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Tuck CZ, Cooper R, Aryeetey R, Gray LA, Akparibo R. A critical review and analysis of the context, current burden, and application of policy to improve cancer equity in Ghana. Int J Equity Health 2023; 22:254. [PMID: 38066530 PMCID: PMC10709985 DOI: 10.1186/s12939-023-02067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable cancer deaths. Despite the World Health Organization calling for governments to develop policies to address this and alleviate cancer inequality, numerous challenges in executing effective cancer policies remain, which require consideration of the country-specific context. As this has not yet been considered in Ghana, the aim of this review was to bring together and critique the social-environmental, health policy and system factors to identifying opportunities for future health policies to reduce cancer burden in the Ghanian context. A critical policy-focused review was conducted to bring together and critique the current health systems context relating to cancer in Ghana, considering the unmet policy need, health system and social factors contributing to the burden and policy advances related to cancer. CONCLUSION The findings highlight the changing burden of cancer in Ghana and the contextual factors within the socio-ecosystem that contribute to this. Policies around expanding access to and coverage of services, as well as the harmonization with medical pluralism have potential to improve outcomes and increase equity but their implementation and robust data to monitor their impact pose significant barriers.
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Affiliation(s)
- Chloe Zabrina Tuck
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
- School of Public Health, University of Ghana, Accra, Ghana.
| | - Richard Cooper
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | | | - Laura A Gray
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Robert Akparibo
- School of Medicine and Population Health, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
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Iddrisu M, Doat AR, Abdulai AM, Wuni A. They patronize herbal medicine, coincidence or planned behaviour: A case of hypertensive patients in Tamale? Nurs Open 2023. [PMID: 37060167 DOI: 10.1002/nop2.1754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/08/2023] [Accepted: 03/24/2023] [Indexed: 04/16/2023] Open
Abstract
AIM This study assessed, if use of herbal medicine (HM) among hypertensive patients is coincidence or planned. DESIGN Cross-sectional survey. METHODS The study used a cross-sectional survey for collection of data from four (4) herbal medicine clinics in the Tamale metropolis in northern Ghana. RESULTS The final or overall regression model was significant at R2 = 0.350, F(7, 214) = 16.464, p < 0.001. No sociodemographic characteristic predicted herbal medicine use. Only religion and educational level were associated with herbal medicine use. Attitude (p = 0.002), subjective norms (p = 0.001) and behavioural intention (p = 0.000) significantly predicted HM use. PUBLIC CONTRIBUTION Data were collected from respondents only after they had verbally given free and informed consent to take part in the study. The results of this study therefore showed that herbal medicine use among these patients is not coincidence but planned. Health professionals by this study should appreciate the effect of religion and educational background in their health education on Herbal Medicines.
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Affiliation(s)
| | - Abdul Razak Doat
- Department of Nursing, School of Nursing and Midwifery, CK Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | | | - Abubakari Wuni
- Nursing and Midwifery Training College, Tamale, Ghana
- Department of medicine for the elderly, Cambridge University Hospital's NHS Foundation, Adddenrookes Hospital, Cambridge United Kingdom, Cambridge, United Kingdom
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Easy Access to Biomedicine and Knowledge about Medicinal Plants: A Case Study in a Semiarid Region of Brazil. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5073625. [PMID: 35911135 PMCID: PMC9334072 DOI: 10.1155/2022/5073625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022]
Abstract
We aimed to evaluate how proximity to urban areas interferes with the relationship between socioeconomic variables and various aspects of medicinal plant knowledge. The study was conducted in six communities of the Catimbau National Park (PARNA Catimbau) in the state of Pernambuco. Eighty participants were interviewed. The communities were divided into two groups according to their distance from the nearest urban center. Socioeconomic data and information on medicinal plants were collected through semistructured interviews. Subsequently, generalized linear models were generated to verify the influence of the interaction between the variables on medicinal knowledge. We observed that proximity to the urban center influenced the relationship between the level of education and the knowledge of body systems treated by medicinal plants. We concluded that environmental variables can generate a differentiated effect on the influence of socioeconomic factors on one's knowledge of medicinal plants.
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Peprah P, Appiah-Brempong E, Agyemang-Duah W, Okyere P, Gyimah AA. ‘Where were pharmaceuticals in Eden?’ Use of herbal medicine in old age: focus group discussions among community-dwelling older adults in Ghana. J Herb Med 2022. [DOI: 10.1016/j.hermed.2022.100549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kretchy IA, Boadu JA, Kretchy JP, Agyabeng K, Passah AA, Koduah A, Opuni KFM. Utilization of complementary and alternative medicine for the prevention of COVID-19 infection in Ghana: A national cross-sectional online survey. Prev Med Rep 2021; 24:101633. [PMID: 34777985 PMCID: PMC8575551 DOI: 10.1016/j.pmedr.2021.101633] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/28/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022] Open
Abstract
82.5% of all participants reported CAM use during the COVID-19 pandemic period. 69.1% of CAM users intended it for COVID-19 infection prevention. Commonly used CAM include vitamins, spiritual healing/prayer, minerals and herbals. Age, sex and COVID-19 illness perception significantly predicted CAM use.
Complementary and alternative medicine (CAM) use is widespread and has played critical roles in preventing infections, including previous coronaviruses. This study sought to document current practices in the use of CAM for the prevention of COVID-19 disease in Ghana. An anonymous electronic survey was conducted from February 1, 2021 to April 30, 2021. Data on demographic characteristics, basic clinical information, illness perceptions about COVID-19, and CAM use during the pandemic period were generated. While about 82.5% (986/1195) of the participants used CAM during the COVID-19 period, 69.1% (681/986) of CAM users intented it for COVID-19 infection prevention. Vitamin supplements (88.1%, 869/986), spiritual healing/prayer (23.3%, 230/986), mineral supplements (22.3%, 220/986), botanical/herbal medicines (22.2%, 219/986), and diet therapy (19.4%, 191/986) were the main types of CAM used. From the adjusted binary logistic regression model, current age (aOR: 1.03, 95%CI: 1.01–1.05), sex (aOR: 1.41, 95%CI: 1.02–1.95), participants’ perceptions of consequences (aOR: 1.10, 95%CI: 1.04–1.17), identity (aOR: 1.15, 95%CI: 1.06–1.25) and concerns about COVID-19 (aOR: 0.91, 95%CI: 0.85–0.97) were statistically significant predictors of CAM use. These results suggest the need for appropriate public health policy on COVID-19 and CAM use in addition to directing further research initiatives toward an optimized COVID-19 prevention scheme using clinically validated CAM treatments. Research to validate the clinical efficacy of these products, especially the herbs, for COVID-19 prevention while isolating lead compounds that could be optimized and used for the treatment and prevention of COVID-19 is also recommended.
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Affiliation(s)
- Irene A Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Joseph A Boadu
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - James-Paul Kretchy
- Department of Physician Assistantship Studies, School of Medicine and Health Sciences, Central University, Miotso, Accra, Ghana
| | - Kofi Agyabeng
- Department of Mathematics, KU Leuven, Leuven, Belgium
| | - Alfred A Passah
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
| | - Kwabena F M Opuni
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Ghana, P.O. Box LG43, Legon, Accra, Ghana
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Hughes GD, Aboyade OM, Okonji CO, Clark B, Mabweazara SZ. Comparison of the prevalence of non-communicable diseases and traditional herbal medicine use in urban and rural communities in South Africa. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Farley E, Bala HM, Lenglet A, Mehta U, Abubakar N, Samuel J, de Jong A, Bil K, Oluyide B, Fotso A, Stringer B, Cuesta JG, Venables E. 'I treat it but I don't know what this disease is': a qualitative study on noma (cancrum oris) and traditional healing in northwest Nigeria. Int Health 2020; 12:28-35. [PMID: 31504549 PMCID: PMC6964223 DOI: 10.1093/inthealth/ihz066] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/06/2019] [Accepted: 06/25/2019] [Indexed: 11/12/2022] Open
Abstract
Background Noma, a neglected disease mostly affecting children, with a 90% mortality rate if untreated, is an orofacial gangrene that disintegrates the tissues of the face in <1 wk. Noma can become inactive with early stage antibiotic treatment. Traditional healers, known as mai maganin gargajiya in Hausa, play an important role in the health system and provide care to noma patients. Methods We conducted 12 in-depth interviews with caretakers who were looking after noma patients admitted at the Noma Children's Hospital and 15 traditional healers in their home villages in Sokoto state, northwest Nigeria. We explored perceptions of noma, relationship dynamics, healthcare practices and intervention opportunities. Interviews were audiorecorded, transcribed and translated. Manual coding and thematic analysis were utilised. Results Traditional healers offered specialised forms of care for specific conditions and referral guidance. They viewed the stages of noma as different conditions with individualised remedies and were willing to refer noma patients. Caretakers trusted traditional healers. Conclusions Traditional healers could play a crucial role in the early detection of noma and the health-seeking decision-making process of patients. Intervention programmes should include traditional healers through training and referral partnerships. This collaboration could save lives and reduce the severity of noma complications.
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Affiliation(s)
- Elise Farley
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria.,Department of Public Health Medicine, University of Cape Town, Anzio Rd, Observatory, Cape Town, South Africa
| | - Hussaina Muhammad Bala
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria
| | - Annick Lenglet
- Médecins Sans Frontières, Plantage Middenlaan 14, 1018 DD, Amsterdam, The Netherlands.,Department of Medical Microbiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands
| | - Ushma Mehta
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Anzio Rd, Observatory, Cape Town, South Africa
| | - Nura Abubakar
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria
| | - Joseph Samuel
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria
| | - Annette de Jong
- Médecins Sans Frontières, Plantage Middenlaan 14, 1018 DD, Amsterdam, The Netherlands
| | - Karla Bil
- Médecins Sans Frontières, Plantage Middenlaan 14, 1018 DD, Amsterdam, The Netherlands
| | - Bukola Oluyide
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria
| | - Adolphe Fotso
- Médecins Sans Frontières, Médecins Sans Frontières, Noma Children's Hospital, Mamarun Nufawa, Sokoto, Nigeria Sokoto, Nigeria
| | - Beverley Stringer
- Médecins Sans Frontières, Lower Ground Floor, Chancery Exchange, 10 Furnival Street, London, UK
| | - Julita Gil Cuesta
- Médecins Sans Frontières-Operational Centre Brussels, Medical Department, 68 Rue de Gasperich, 1617, Luxembourg Operational Research Unit (LuxOR)
| | - Emilie Venables
- Médecins Sans Frontières-Operational Centre Brussels, Medical Department, 68 Rue de Gasperich, 1617, Luxembourg Operational Research Unit (LuxOR).,Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa
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Oppong Bekoe E, Agyare C, Boakye YD, Baiden BM, Asase A, Sarkodie J, Nettey H, Adu F, Otu PB, Agyarkwa B, Amoateng P, Asiedu-Gyekye I, Nyarko A. Ethnomedicinal survey and mutagenic studies of plants used in Accra metropolis, Ghana. JOURNAL OF ETHNOPHARMACOLOGY 2020; 248:112309. [PMID: 31654798 DOI: 10.1016/j.jep.2019.112309] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/22/2019] [Accepted: 10/13/2019] [Indexed: 02/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Majority of people living in Ghana and many other developing countries rely on traditional medicinal plants for their primary healthcare. These plants are used either alone or in combination to manage a wide range of ailments. However, most of these plants have not been investigated for their mutagenic effects. AIM OF THE STUDY This study, therefore aimed at evaluating the mutagenic activity of the most frequently used medicinal plants amongst Ghanaians living within the Accra metropolis, Ghana. MATERIALS AND METHODS Validated questionnaires were administered to 53 herbalists and herbal medicines dealers in the Makola, Madina and Nima communities. Plants that were identified as being frequently used were investigated for their mutagenicity using the Ames test. RESULTS A total of 110 medicinal plants belonging to 53 families were identified as most frequently used plants in the study sites. These are used to treat various ailments including gastric ulcer, fever, malaria, male impotence, diabetes, typhoid, high blood pressure and candidiasis. Thirteen samples (52%) showed moderate to high mutagenicity in the TA 100 bacterial strain before and after metabolism with rat liver enzyme. CONCLUSIONS The study showed that over half of the frequently used medicinal plants showed moderate to high mutagenicity before and after metabolism at the concentration of a 100 μg/mL. This may have implications for the safety of those who use them to manage diseases. These findings will suggest the need for an in-depth study of the mutagenic potentials of plants commonly used by indigenous people and more especially for those exhibiting high mutagenicity in this study.
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Affiliation(s)
- Emelia Oppong Bekoe
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Christian Agyare
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Yaw Duah Boakye
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Benedict Mbeah Baiden
- Department of Statistics and Actuarial Science, University of Ghana, P.O. Box LG 115, University of Ghana, Legon, Accra, Ghana.
| | - Alex Asase
- Department of Plant and Environmental Science, University of Ghana, P.O. Box LG55, University of Ghana, Legon, Accra, Ghana.
| | - Joseph Sarkodie
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Henry Nettey
- Department of Pharmaceutics and Microbiology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Francis Adu
- Department of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Priscilla Boatema Otu
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Benjamin Agyarkwa
- Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Patrick Amoateng
- Department of Pharmacology and Toxicology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Isaac Asiedu-Gyekye
- Department of Pharmacology and Toxicology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
| | - Alexander Nyarko
- Department of Pharmacology and Toxicology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana.
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Nyaaba GN, Agyemang C, Masana L, de-Graft Aikins A, Beune E, Larrea-Killinger C, Stronks K. Illness representations and coping practices for self-managing hypertension among sub-Saharan Africans: A comparative study among Ghanaian migrants and non-migrant Ghanaians. PATIENT EDUCATION AND COUNSELING 2019; 102:1711-1721. [PMID: 30992171 DOI: 10.1016/j.pec.2019.04.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Hypertension (HTN) control is a major obstacle among sub-Saharan African populations partly due to poor self-management. We explored and compared how persons' social and physical context shapes their illness representations regarding HTN and the coping strategies they develop and adapt to mitigate challenges in self-managing HTN. METHODS A cross sectional multisite qualitative study using semi-structured interviews among 55 Ghanaians with HTN living in The Netherlands and urban and rural Ghana. A thematic approach was used in data analysis. RESULTS Family HTN history, personal experiences with HTN and outcomes of using biomedical and traditional treatments shaped participants' illness representations and coping strategies. Migrants and urban non-migrants modified medication schedules and integrated taking medication into daily routine activities to cope with experienced side effects of taking antihypertensive medication while rural non-migrants used traditional remedies and medicines to mitigate experienced medication side effects and/or in search for a cure for HTN. CONCLUSION Contextual factors within participants' social and physical environments shape their illness representations and coping strategies for HTN though interactive phrases. PRACTICE IMPLICATIONS Health professionals should harness the relationships within peoples' social and physical environments, encourage implementation of family-wide behavioural changes and involve family and communities in HTN treatment to enhance patients' self-management of HTN.
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Affiliation(s)
- Gertrude Nsorma Nyaaba
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Barcelona Institute for Global Health (IS Global), University of Barcelona, Barcelona, Spain.
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Lina Masana
- Barcelona Institute for Global Health (IS Global), University of Barcelona, Barcelona, Spain; Medical Anthropology Research Centre-URV Tarragona, Spain
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Erik Beune
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | | | - Karien Stronks
- Department of Public Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Amoah A, Duma SE. Factors contributing to primary caregiver delay in presenting children with chronic kidney disease for medical care in Ghana. Afr J Prim Health Care Fam Med 2019; 11:e1-e7. [PMID: 31478743 PMCID: PMC6739531 DOI: 10.4102/phcfm.v11i1.1894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 01/29/2019] [Accepted: 03/23/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Conforming to the 2016 World Kidney Day focus on raising awareness of the early detection of kidney diseases in children, we report on factors that contribute to primary caregiver delay in presenting their children with chronic kidney disease (CKD) for medical care in Kumasi, Ghana. AIM The objective of the study was to explore and describe the factors that contribute to primary caregiver delay in presenting children with CKD for medical care in Kumasi, Ghana. SETTING The study was conducted in the Paediatric Renal Unit in Kumasi, Ghana. METHODS A qualitative study was conducted in January 2017. Semi-structured interviews were used to collect data from a convenience sample of 10 primary caregivers whose children were admitted for CKD, but were not too ill. The primary caregivers had to respond to the research question: What factors contribute to your delay in presenting your child with CKD for medical care? Thematic data analysis and the ecological model of Schneider (2017) were used to organise the findings. RESULTS Four themes and related subthemes, including intrapersonal-related factors, interpersonal-related factors, community-related factors and infrastructural factors were identified as those that contribute to delay in presenting children with CKD for medical care. CONCLUSION The findings show that primary prevention strategies for CKD in children should not only focus on personal-related factors but also cut across all levels of the socio-ecological model in order for them to be effective.
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Affiliation(s)
- Abigail Amoah
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban.
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Demography, Socioeconomic Status and Health Services Utilisation among Older Ghanaians: Implications for Health Policy. AGEING INTERNATIONAL 2018. [DOI: 10.1007/s12126-018-9343-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health 2018; 3:e000895. [PMID: 30483405 PMCID: PMC6231111 DOI: 10.1136/bmjgh-2018-000895] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022] Open
Abstract
Background The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region. Methods We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken. Results Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers. Conclusion TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Gyasi RM, Poku AA, Boateng S, Amoah PA, Mumin AA, Obodai J, Agyemang-Duah W. Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2018; 15:44-55. [PMID: 28088259 DOI: 10.1016/s2095-4964(17)60312-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana. METHODS In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. RESULTS Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. CONCLUSION In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong, China.,Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Adjoa Afriyie Poku
- Department of Geography Education, Faculty of Social Science Education, University of Education, Winneba, Ghana
| | - Simon Boateng
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Padmore Adusei Amoah
- Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong, China
| | - Alhassan Abdul Mumin
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jacob Obodai
- Department of Planning and Development, Christian Service University College, Kumasi, Ghana
| | - Williams Agyemang-Duah
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Kyei MY, Klufio GO, Ayamba A, Mohammed S. Traditional medicines and alternative practice in the management of prostate diseases in southern Ghana. Ghana Med J 2018; 51:128-137. [PMID: 29622824 DOI: 10.4314/gmj.v51i3.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective This study was aimed at identifying Ghanaian traditional medicines used for the management of prostate diseases and their constituents. Reviews of studies conducted on them are also presented. Methodology This was a prospective study. Traditional Medicine samples from consecutive patients with either lower urinary symptoms (LUTS) presenting at the Urology Unit of the Korle Bu Teaching Hospital (KBTH) in Accra from January 2015 to June 2016 and had a prior treatment with traditional medicines, had the samples retrieved. Additionally, all the 58 licensed pharmaceutical shops in Okaishie, a whole sale and retail depot for medicines in the main business district of Accra, were visited and traditional medicines for the management of prostate diseases acquired. The products constituent as labeled were documented and entered once on a proforma. This study was part of a study on the management of benign prostate hyperplasia at the KBTH approved by the Medical Directorate.The findings were analyzed and presented using descriptive statistics and presented as a table. Results Eleven products were identified with the main indigenous medicinal plant identified being the root extract of Croton membranaceus. This was the constituent in four products (Uro 500®, UR-Quick mixture®, Prostacure® and prostat®60). Although studies on the basic pharmacology and animal studies have confirmed its effect on the prostate, only one clinical study was identified. Conclusion Croton membranaceus was the indigenous traditional medicine identified for relieving LUTS due to prostate disease. There is the need for empirical evidence on its efficacy in treating Prostate cancer. Funding Not declared.
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Affiliation(s)
- Mathew Y Kyei
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
| | - George O Klufio
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
| | - Ali Ayamba
- The University of Health and Allied Health Sciences, PMB 31, Ho, Volta Region, Ghana
| | - Sherif Mohammed
- Department of Surgery, School of Medicine and Dentistry, College of Health Sciences, University of Ghana, P. O. Box 4236, Accra, Ghana
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Gyasi RM. Unmasking the Practices of Nurses and Intercultural Health in Sub-Saharan Africa: A Useful Way to Improve Health Care? J Evid Based Integr Med 2018; 23:2515690X18791124. [PMID: 30101602 PMCID: PMC6090495 DOI: 10.1177/2515690x18791124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In 2001 and 2013, the World Health Organization (WHO) published the WHO
Traditional Medicine Strategy 2002-2005 and 2014-2023,
respectively, to address policy, ethics, quality, and integration of complementary health
therapies (CHT). Despite the adoption of these strategic frameworks, sub-Saharan African
(SSA) countries largely run dualistic and inclusive health care system. A
recent article published in Complementary Therapies in Clinical Practice
analyzed the role of practicing nurses in CHT integration and intercultural health in an
SSA country setting. Drawing on the Complementary and Alternative Medicine Health Belief
Questionnaire, the study specifically examined nurses’ knowledge, practices, and attitudes
toward CHT. The study revealed that nurses had low knowledge about CHT, which reflected in
their ineptitude to engage in professional practices of CHT. In spite of the knowledge
deficit, nurses generally held favorable attitudes toward CHT and the majority supported
the need for “safe” and evidence-based integrative model. Efforts to improve CHT-related
knowledge of nurses may enhance medical integration in SSA. This commentary proposes novel
political will and investment in CHT education and research as well as
an inclusion of CHT modules in the nurses’ training programs; viabilities to achieve
intercultural health and improved care in SSA.
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Affiliation(s)
- Razak M Gyasi
- 1 Department of Sociology and Social Policy, Lingnan University, Hong Kong.,2 Centre for Social Policy and Social Change, Lingnan University, Hong Kong
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James PB, Bah AJ, Tommy MS, Wardle J, Steel A. Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study. Women Birth 2017; 31:e302-e309. [PMID: 29254852 DOI: 10.1016/j.wombi.2017.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 11/06/2017] [Accepted: 12/04/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care. AIM This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone. METHODS A cross-sectional study was conducted among pregnant women (n=134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis. RESULTS The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%). CONCLUSION Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Michael Steven Tommy
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Level 8, Building 10, 235-253 Jones Street, Ultimo, NSW 2007, Australia; Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, Brisbane, QLD 4006, Australia.
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Gyasi RM, Abass K, Adu-Gyamfi S, Accam BT, Nyamadi VM. The Capabilities of Nurses for Complementary and Traditional Medicine Integration in Africa. J Altern Complement Med 2017; 24:282-290. [PMID: 28787173 DOI: 10.1089/acm.2017.0133] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Despite the political commitment of national governments and collaborative efforts by the World Health Organization (WHO) toward the actualization of intercultural healthcare system over the past decades, sub-Saharan African countries feature medical cohabitation rather than a truly integrated medical system. This hospital-based cross-sectional study analyzed the capabilities of nurses for complementary and traditional medicine (CTM) integration in Africa. METHOD Practicing nurses (n = 210) were recruited to respond to the CTM Health Belief Questionnaire (CHBQ) in December 2016. Normality of data was evaluated using Kolmogorov-Smirnov statistic with a Lilliefors significance correction. The authors assessed the relationship among nurses' knowledge, personal use, and clinical practice of CTM, using Spearman's Rank Order Correlation (rho). The differences and associations in continuous and categorical baseline variables were determined with Mann-Whitney U test/Kruskal-Wallis H test and Pearson's Chi-square test, respectively, at p < 0.05 as statistically significant. RESULTS The overall mean score of nurses' knowledge of CTM therapies was 38 (interquartile range [IQR] 16). This low CTM-related knowledge reflected in the poor mean performance score of 30 (IQR 17) and 22 (IQR 6) for personal use and clinical practice of CTM, respectively, among nurses. Nurses, therefore, lacked the confidence to recommend CTM therapies to patients. Yet, nurses exhibited a high positive attitude to CTM (72.7 ± 12.5). In addition to significant associations among CTM-related knowledge, education (p = 0.023), and religion (p < 0.001), the study found a positive and statistically significant correlation among CTM-related knowledge, personal use (r = 0.556, p < 0.001), and professional practice of CTM (r = 0.349, p < 0.001). CONCLUSION Given their substantial role in the primary and public healthcare system, improving nurses' knowledge of CTM through evidence-based nursing education and training remains the surest way to achieve appropriate CTM integration in Africa as outlined in the WHO Traditional Medicine Strategy 2014-2023.
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Affiliation(s)
- Razak Mohammed Gyasi
- 1 Department of Sociology and Social Policy, Lingnan University , Tuen Mun, Hong Kong SAR.,2 Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology , Kumasi, Ghana
| | - Kabila Abass
- 2 Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology , Kumasi, Ghana
| | - Samuel Adu-Gyamfi
- 3 Department of History and Political Studies, Kwame Nkrumah University of Science and Technology , Kumasi, Ghana
| | - Burnett Tetteh Accam
- 4 Department of Mathematics, Kwame Nkrumah University of Science and Technology , Kumasi, Ghana
| | - Victoria Mensah Nyamadi
- 5 Department of Planning and Development, Christian Service University College , Kumasi, Ghana
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Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare. Complement Ther Clin Pract 2017; 29:1-8. [PMID: 29122246 DOI: 10.1016/j.ctcp.2017.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. METHOD Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p < 0.05. RESULTS The mean score of nurses' knowledge on CAM therapies was low (mean ± SD, 38.39 ± 10.11; possible range, 18-72) which was built on nurses' personal experiences. Nurses, therefore, lacked the confidence to recommend CAM therapies to patients. Despite the isolated cases of non-herbal supplements, relaxation techniques, massage and prayer healing, the study found an overall low personal use of CAM (mean ± SD, 32.97 ± 10.78; possible range, 18-72) among nurses over the last 12 months. Yet, nurses exhibited a positive attitude towards CAM (mean ± SD, 72.7 ± 12.5, possible range, 67-110). We observed significant associations among nurses' CAM knowledge and education [χ2 (2) = 6.69, p = 0.035] and religion [χ2 (2) = 7.96, p = 0.019]; nurses' personal use of CAM and income [χ2 (2) = 16.07, p < 0.001] and religion [χ2 (2) = 18.65, p < 0.001]; and nurses' clinical CAM use and income [χ2 (2) = 7.01, p = 0.030]. CONCLUSION Despite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM. Integrating CAM education into the nurses' training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana.
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Gyasi R, Buor D, Adu-Gyamfi S, Adjei POW, Amoah PA. Sociocultural hegemony, gendered identity, and use of traditional and complementary medicine in Ghana. Women Health 2017; 58:598-615. [PMID: 28430032 DOI: 10.1080/03630242.2017.1321608] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ˂ .0001), and have health insurance (p ˂ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28-47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002-0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22-47.60), while females' TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21-11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78-17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.
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Affiliation(s)
- Razak Gyasi
- a Department of Sociology and Social Policy , Lingnan University , Tuen Mun , New Territories , Hong Kong.,b Department of Geography and Rural Development , Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Daniel Buor
- b Department of Geography and Rural Development , Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Samuel Adu-Gyamfi
- c Department of History and Political Studies , Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Prince Osei-Wusu Adjei
- b Department of Geography and Rural Development , Kwame Nkrumah University of Science and Technology , Kumasi , Ghana
| | - Padmore Adusei Amoah
- a Department of Sociology and Social Policy , Lingnan University , Tuen Mun , New Territories , Hong Kong
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Gyasi RM, Agyemang-Duah W, Mensah CM, Arthur F, Torkornoo R, Amoah PA. Unconventional medical practices among Ghanaian students: A university-based survey. J Tradit Complement Med 2016; 7:126-132. [PMID: 28053899 PMCID: PMC5198819 DOI: 10.1016/j.jtcme.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/20/2016] [Accepted: 06/11/2016] [Indexed: 01/12/2023] Open
Abstract
Research on unconventional medical practices among students has proliferated lately in the global space, hitherto, little is known explicitly in Ghana. This paper teases out insights for recent utilisation patterns of traditional medical therapies at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. A sample of 754, randomly selected undergraduates were involved in a retrospective cross-sectional survey. Data were analysed using multivariate logistic regression and Pearson's χ2 test with p < 0.05 as significant. Overall prevalence of traditional therapies consumption was 89.1% in the last 12 months. Herbal-based products (67%), prayer healing (15%) and body-mind therapies (11%) were principally used and, accessed through purchases from pharmacy shops (29%) and encounter with faith healers (26%). Although students' knowledge on traditional therapies was acquired through family members (50%) and media (23%), literary materials remained significant information routes for Science related students compared to the Non-science related counterparts (p < 0.001). Pursuing Non-science-related programme [odds ratio (OR) 6.154 (95% confidence interval (CI) 3.745-10.111; p < 0.001)] and having Christian faith [OR 2.450 (95% CI 1.359-4.415; p = 0.003)] were strongly associated with students' traditional therapies use. Although students exhibited positive attitude towards unconventional therapies, there is an urgent need to validate the quality of traditional therapies through randomised clinical trials and regulatory practices to ensure quality control. Health forces should intensify efforts towards intercultural health care system in Ghana.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong Special Administrative Region; Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Williams Agyemang-Duah
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Arthur
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Roselyn Torkornoo
- Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Padmore Adusei Amoah
- Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong Special Administrative Region
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Gyasi RM, Asante F, Yeboah JY, Abass K, Mensah CM, Siaw LP. Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana. Int J Qual Stud Health Well-being 2016; 11:29667. [PMID: 27018431 PMCID: PMC4808739 DOI: 10.3402/qhw.v11.29667] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/28/2015] [Indexed: 11/14/2022] Open
Abstract
The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of one's health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.
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Affiliation(s)
- Razak Mohammed Gyasi
- Department of Sociology and Social Policy, Lingnan University, Tuen Mun, New Territories, Hong Kong SAR.,Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana;
| | - Felix Asante
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Joseph Yaw Yeboah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kabila Abass
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charlotte Monica Mensah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Tran BX, Nguyen NK, Nguyen LP, Nguyen CT, Nong VM, Nguyen LH. Preference and willingness to pay for traditional medicine services in rural ethnic minority community in Vietnam. Altern Ther Health Med 2016; 16:48. [PMID: 26841925 PMCID: PMC4739329 DOI: 10.1186/s12906-016-1010-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/22/2016] [Indexed: 11/26/2022]
Abstract
Background Traditional 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. Methods A cross-sectional survey in three provinces in the North and South of Vietnam. Results The 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. Conclusions Ethnic minority people prefer the use of traditional medicine services that supports the expansion of national programs and promotion of traditional medications.
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Hughes GD, Aboyade OM, Beauclair R, Mbamalu ON, Puoane TR. Characterizing Herbal Medicine Use for Noncommunicable Diseases in Urban South Africa. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:736074. [PMID: 26557865 PMCID: PMC4629029 DOI: 10.1155/2015/736074] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/16/2015] [Indexed: 01/10/2023]
Abstract
Economic challenges associated with noncommunicable diseases (NCDs) and the sociocultural outlook of many patients especially in Africa have increased dependence on traditional herbal medicines (THMs) for these diseases. A cross-sectional descriptive study designed to determine the prevalence of and reasons for THM use in the management of NCDs among South African adults was conducted in an urban, economically disadvantaged area of Cape Town, South Africa. In a cohort of 1030 participants recruited as part of the existing Prospective Urban and Rural Epidemiological (PURE) study, 456 individuals were identified. The overall prevalence of THM use was 27%, of which 61% was for NCDs. Participants used THM because of a family history (49%) and sociocultural beliefs (33%). Hypertensive medication was most commonly used concurrently with THM. Healthcare professionals need to be aware of the potential dualistic use of THM and conventional drugs by patients, as this could significantly influence health outcomes. Efforts should be made to educate patients on the potential for drug/herb interactions.
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Affiliation(s)
- Gail D. Hughes
- South African Herbal Science and Medicine Institute (SAHSMI), Faculty of Natural Sciences, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Oluwaseyi M. Aboyade
- South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville 7535, South Africa
| | - Roxanne Beauclair
- The South African Centre for Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch 7602, South Africa
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP114, 9000 Gent, Belgium
| | - Oluchi N. Mbamalu
- School of Pharmacy, University of the Western Cape, Bellville 7535, South Africa
| | - Thandi R. Puoane
- School of Public Health, University of the Western Cape, Bellville 7535, South Africa
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Relationship between Health Insurance Status and the Pattern of Traditional Medicine Utilisation in Ghana. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:717926. [PMID: 26347791 PMCID: PMC4548134 DOI: 10.1155/2015/717926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 06/27/2015] [Accepted: 07/21/2015] [Indexed: 11/17/2022]
Abstract
This paper examines the relationship between national health insurance status and the pattern of traditional medicine (TRM) use among the general population in Ghana. A retrospective cross-sectional survey of randomly sampled adults, aged ≥18 years (N = 324), was conducted. The results indicate that TRM use was high with prevalence of over 86%. The study found no statistically significant association between national health insurance status and TRM utilisation (P > 0.05). Paradoxically, major sources of TRM, frequency of TRM use, comedical administration, and disclosure of TRM use to health care professionals differed significantly between the insured and uninsured subgroups (P < 0.001). Whereas effectiveness of TRM predicted its use for both insured [odds ratio (OR) = 4.374 (confidence interval (CI): 1.753-10.913; P = 0.002)] and uninsured [OR = 3.383 CI: 0.869-13.170; P = 0.039)], work experience predicted TRM use for the insured [OR = 1.528 (95% CI: 1.309-1.900; P = 0.019)]. Cultural specific variables and health philosophies rather than health insurance status may influence health care-seeking behaviour and TRM use. The enrollment of herbal-based therapies on the national health insurance medicine plan is exigent to ensure monitoring and rational use of TRM towards intercultural health care system in Ghana.
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Gyasi RM, Asante F, Segbefia AY, Abass K, Mensah CM, Siaw LP, Eshun G, Adjei POW. Does spatial location matter? Traditional therapy utilisation among the general population in a Ghanaian rural and urban setting. Complement Ther Med 2015; 23:439-50. [DOI: 10.1016/j.ctim.2015.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/15/2015] [Accepted: 04/04/2015] [Indexed: 10/23/2022] Open
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