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Sarmiento I, Paredes-Solís S, De Jesús-García A, Maciel-Paulino N, Meneses-Rentería A, Amaya C, Cockcroft A, Andersson N. Traditional Midwifery Contribution to Safe Birth in Cultural Safety: Narrative Evaluation of an Intervention in Guerrero, Mexico. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:377-389. [PMID: 36189713 PMCID: PMC11143758 DOI: 10.1177/0272684x221120481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A 2017 randomised controlled trial in Guerrero State, Mexico, showed supporting Indigenous traditional midwives on their own terms improved traditional childbirths without inferior maternal health outcomes. This narrative evaluation complements the trial to document participant experience of safer birth in cultural safety, transformative dynamics and implementation issues of the intervention. Stories came from 26 traditional midwives, 28 apprentices, 12 intercultural brokers and 20 Indigenous women who experienced the intervention. Their accounts indicate the intervention revitalised traditional midwifery and consolidated local skills through traditional midwife apprentices and intercultural brokers to support safe birth. According to the stories, communities reintroduced traditional perinatal care and reported positive health impacts for mothers, children, and other adults, which contributed to early collaboration with official health services. Challenges included remuneration and disinterest of younger apprentices and brokers. The intervention seems to have improved interaction between traditional and Western services, setting the stage for further intercultural dialogue.
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Affiliation(s)
- Iván Sarmiento
- CIET-PRAM, Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Grupo de Estudios en Sistemas Tradicionales de Salud, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, México
| | - Abraham De Jesús-García
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, México
| | - Nadia Maciel-Paulino
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, México
| | - Alba Meneses-Rentería
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, México
| | - Carolina Amaya
- Grupo de Estudios en Sistemas Tradicionales de Salud, Universidad del Rosario, Bogotá, Colombia
| | - Anne Cockcroft
- CIET-PRAM, Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Neil Andersson
- CIET-PRAM, Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, México
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Vazquez-Brust DA, Arthur-Holmes F, Yakovleva N. The social and environmental responsibility of informal artisanal and small-scale mining in Ghana: An Akan philosophical perspective. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2024; 360:121131. [PMID: 38759560 DOI: 10.1016/j.jenvman.2024.121131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
Informal artisanal and small-scale mining (ASM) continues to grow globally, raising both challenges and opportunities in terms of economic, social, and environmental impacts. The ASM literature explores the formalization and transfer of corporate social responsibility (CSR) practices from larger firms as the pathway to minimize negative impacts and maximize benefits. But we know very little about environmental and social responsibilities of informal mining operations (and informal economy actors in general, who are often portrayed as devoid of these responsibilities). This paper aims to theorize and empirically explore principles and practices of social and environmental responsibility in informal mining. We combine elements of relational stakeholder theory with Ghana's Akan philosophy to develop our theoretical framework. Through a qualitative research process involving thematic analysis - of field notes from field observations and 81 interviews with ASM miners, community leaders/residents and executive members of Small-Scale Mining Association-Prestea Branch in Ghana - and pattern-matching technique, we find that: a) informal ASM is culturally and relationally motivated to be socially and environmentally responsible, b) there is a model of informal social and environmental responsibility (ISER) that is characterized by commonality, solidarity, tradition, and human-nature interdependencies, and c) social and environmental responsibilities are interpreted in a distinctive, non-Western way and comply with two main informal norms: gifting for social responsibilities and taboos for environmental responsibility. We conclude by suggesting that governments should collaborate with traditional authorities to promote ISER practices as cultural norms.
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Affiliation(s)
- Diego Alfonso Vazquez-Brust
- School of Strategy, Marketing and Innovation (SMI), Faculty of Business and Law, University of Portsmouth, Richmond Building, Portsmouth PO1 3DE, United Kingdom.
| | - Francis Arthur-Holmes
- School of Strategy, Marketing and Innovation (SMI), Faculty of Business and Law, University of Portsmouth, Richmond Building, Portsmouth PO1 3DE, United Kingdom; Agile Centre for Equitable Sustainability (ACES), University of Portsmouth, Richmond Building, Portsmouth PO1 3DE, United Kingdom.
| | - Natalia Yakovleva
- Department of Strategy, Sustainability and Entrepreneurship, KEDGE Business School, 40 Avenue des Terroirs de France, 75012 Paris, France.
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Sarmiento I, Cockcroft A, Dion A, Belaid L, Silver H, Pizarro K, Pimentel J, Tratt E, Skerritt L, Ghadirian MZ, Gagnon-Dufresne MC, Andersson N. Fuzzy cognitive mapping in participatory research and decision making: a practice review. Arch Public Health 2024; 82:76. [PMID: 38769567 PMCID: PMC11103993 DOI: 10.1186/s13690-024-01303-7] [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: 07/25/2023] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Fuzzy cognitive mapping (FCM) is a graphic technique to describe causal understanding in a wide range of applications. This practice review summarises the experience of a group of participatory research specialists and trainees who used FCM to include stakeholder views in addressing health challenges. From a meeting of the research group, this practice review reports 25 experiences with FCM in nine countries between 2016 and 2023. RESULTS The methods, challenges and adjustments focus on participatory research practice. FCM portrayed multiple sources of knowledge: stakeholder knowledge, systematic reviews of literature, and survey data. Methodological advances included techniques to contrast and combine maps from different sources using Bayesian procedures, protocols to enhance the quality of data collection, and tools to facilitate analysis. Summary graphs communicating FCM findings sacrificed detail but facilitated stakeholder discussion of the most important relationships. We used maps not as predictive models but to surface and share perspectives of how change could happen and to inform dialogue. Analysis included simple manual techniques and sophisticated computer-based solutions. A wide range of experience in initiating, drawing, analysing, and communicating the maps illustrates FCM flexibility for different contexts and skill bases. CONCLUSIONS A strong core procedure can contribute to more robust applications of the technique while adapting FCM for different research settings. Decision-making often involves choices between plausible interventions in a context of uncertainty and multiple possible answers to the same question. FCM offers systematic and traceable ways to document, contrast and sometimes to combine perspectives, incorporating stakeholder experience and causal models to inform decision-making. Different depths of FCM analysis open opportunities for applying the technique in skill-limited settings.
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Affiliation(s)
- Iván Sarmiento
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada.
- Universidad del Rosario, Grupo de Estudios en Sistemas Tradicionales de Salud, Bogota, Colombia.
| | - Anne Cockcroft
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Anna Dion
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Loubna Belaid
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Hilah Silver
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Katherine Pizarro
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Juan Pimentel
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
- Facultad de Medicina, Universidad de La Sabana, Chía, Colombia
| | - Elyse Tratt
- Institut Lady Davis pour la Recherche Médicale, Montreal, Canada
| | - Lashanda Skerritt
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Mona Z Ghadirian
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Marie-Catherine Gagnon-Dufresne
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
- École de santé publique, Département de médecine sociale et préventive, Université de Montréal, Montreal, Canada
| | - Neil Andersson
- Department of Family Medicine, McGill University, 5858 Ch. de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Wei A, Zhang YB, Robertson E, Steen J, Mushquash C, Wekerle C. Global Indigenous gender concepts, gender-based violence and resilience: A scoping review. CHILD ABUSE & NEGLECT 2024; 148:106185. [PMID: 37087390 DOI: 10.1016/j.chiabu.2023.106185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/23/2023] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND & OBJECTIVE The legacy of colonialism includes ongoing trauma and disruption of traditional teachings on relationality, which has contributed to Indigenous populations being disproportionately exposed to gender-based violence (GBV). GBV in Indigenous populations is explored to consider gender-specific findings and points of resilience in relational networks. PARTICIPANTS & SETTING Included articles sampled Indigenous groups in Canada, US, Mexico, Guatemala, and Israel. All participants self-identified as Indigenous, and were either GBV survivors or service providers working in GBV contexts. METHODS A scoping review was conducted in OVID Medline, Embase, APA Psycinfo, and Informit Indigenous Collection, using keywords for Indigenous peoples, gender concepts, and GBV. Articles were screened and extracted by two reviewers; a third reviewer resolved conflicts. RESULTS Our search yielded one mixed-method study and seven qualitative studies, all published since 2016. North American studies identified colonial, patriarchal disruptions (e.g. residential schools) to positive pre-contact gender norms (e.g. non-hierarchical roles) that contribute to emerging GBV. Studies conducted in Guatemala and Israel also described local patriarchal cultures contributing to GBV. Lack of understanding of the Two-Spirit identity (i.e. supra-binary gender identity used by Indigenous persons) led to harmful attitudes and stigma. Interpersonal support and return to traditional matriarchal practices were identified as key resilience processes. CONCLUSIONS There is limited literature on Indigenous gender concepts and GBV, particularly regarding GBV against males and Two-Spirit persons. Colonization-related violence and/or patriarchal gender norms were identified as precursors for GBV. Decolonization processes should be further explored to address GBV in Indigenous populations.
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Affiliation(s)
- Angela Wei
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
| | - Yang Bo Zhang
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Emma Robertson
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jeremy Steen
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Christopher Mushquash
- Department of Psychology and Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada
| | - Christine Wekerle
- Department of Pediatrics, Faculty of Health Sciences, and Department of Psychiatry and Behavioral Neuroscience, Faculty of Science, McMaster University, Hamilton, Ontario, Canada; Optentia Research Unit, North-West University, South Africa
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Sarmiento I, Rojas-Cárdenas A, Zuluaga G, Belaid L, Cockcroft A, Andersson N. Experimental studies testing interventions to promote cultural safety, interculturality or antiracism in healthcare: protocol for a systematic review. BMJ Open 2024; 14:e077227. [PMID: 38171628 PMCID: PMC10773383 DOI: 10.1136/bmjopen-2023-077227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/19/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Cultural safety, interculturality and antiracism are crucial concepts in addressing health disparities of minority and diverse groups. Measuring them is challenging, however, due to overlapping meanings and their highly contextual nature. Community engagement is essential for evaluating these concepts, yet the methods for social inclusion and protocols for participation remain unclear. This review identifies experimental studies that measure changes resulting from culturally safe, intercultural or antiracist healthcare. The review will describe outcomes and additional factors addressed in these studies. METHODS AND ANALYSIS The study focuses on epidemiological experiments with counterfactual comparisons and explicit interventions involving culturally safe, intercultural or antiracist healthcare. The search strategy covers PubMed, CINAHL, Scopus, Web of Science, ProQuest, LILACS and WHO IRIS databases. We will use critical appraisal tools from the Joanna Briggs Institute to assess the quality of randomised and non-randomised experimental studies. Two researchers will screen references, select studies and extract data to summarise the main characteristics of the studies, their approach to the three concepts under study and the reported effect measures. We will use fuzzy cognitive mapping models based on the causal relationships reported in the literature. We will consider the strength of the relationships depicted in the maps as a function of the effect measure reported in the study. Measures of centrality will identify factors with higher contributions to the outcomes of interest. Illustrative intervention modelling will use what-if scenarios based on the maps. ETHICS AND DISSEMINATION This review of published literature does not require ethical approval. We will publish the results in a peer-reviewed journal and present them at conferences. The maps emerging from the process will serve as evidence-based models to facilitate discussions with Indigenous communities to further the dialogue on the contributing factors and assessment of cultural safety, interculturality and antiracism. PROSPERO REGISTRATION NUMBER CRD42023418459.
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Affiliation(s)
- Ivan Sarmiento
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- GESTS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, Cundinamarca, Colombia
| | - Andrés Rojas-Cárdenas
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Germán Zuluaga
- GESTS, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota, Cundinamarca, Colombia
- Centro de Estudios Médicos Interculturales (CEMI), Cota, Cundinamarca, Colombia
| | - Loubna Belaid
- École nationale d'administration publique (ENAP), Quebec, Quebec, Canada
| | - Anne Cockcroft
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Neil Andersson
- CIET-PRAM, Department of Family Medicine, McGill University, Montreal, Quebec, Canada
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, Mexico
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Pillai P, Rawat M, Jain S, Martin RA, Shelly K, Mathias K. Developing relevant community mental health programmes in North India: five questions we ask when co-producing knowledge with experts by experience. BMJ Glob Health 2023; 8:e011671. [PMID: 37652565 PMCID: PMC10476121 DOI: 10.1136/bmjgh-2022-011671] [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: 12/30/2022] [Accepted: 05/24/2023] [Indexed: 09/02/2023] Open
Abstract
Knowledge co-production can improve the quality and accessibility of health, and also benefit service users, allowing them to be recognised as skilled and capable. Yet despite these clear benefits, there are inherent challenges in the power relations of co-production, particularly when experts by experience (EBE) are structurally disadvantaged in communication skills or literacy. The processes of how knowledge is co-produced and negotiated are seldom described. This paper aims to describe processes of co-production building on the experiences of EBE (people with lived experience of psychosocial or physical disability), practitioners and researchers working together with a non-profit community mental health programme in North India. We describe processes of group formation, relationship building, reflexive discussion and negotiation over a 7-year period with six diverse EBE groups. Through a process of discussion and review, we propose these five questions which may optimise co-production processes in communities: (1) Who is included in co-production? (2) How can we optimise participation by people with diverse sociodemographic identities? (3) How do we build relationships of trust within EBE groups? (4) How can we combine psychosocial support and knowledge co-production agendas in groups? and (5) How is the expertise of experts by experience acknowledged?
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Affiliation(s)
- Pooja Pillai
- Community Health and Development Program, Herbertpur Christian Hospital, Herbertpur, India
| | - Meenal Rawat
- Community Health and Development Program, Herbertpur Christian Hospital, Herbertpur, India
- School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
| | - Sumeet Jain
- School of Social and Political Science, The University of Edinburgh, Edinburgh, UK
| | | | - Kakul Shelly
- Community Health and Development Program, Herbertpur Christian Hospital, Herbertpur, India
| | - Kaaren Mathias
- Community Health and Development Program, Herbertpur Christian Hospital, Herbertpur, India
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
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Schaub R, Ottevanger MSMD, Harkisoen S, Pesna B, Duijves C, Heemskerk M, Polime T, Tuaillon E, Vreden S, Nacher M. Involving hard-to-reach populations is pivotal for the tailoring and implementation of an epidemiological study in cross-border communities of French Guiana and Suriname. Front Public Health 2023; 11:1162705. [PMID: 37325314 PMCID: PMC10266529 DOI: 10.3389/fpubh.2023.1162705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/09/2023] [Indexed: 06/17/2023] Open
Abstract
Background Hard-to-reach, vulnerable and cross-border populations are often disproportionately affected by communicable diseases. Epidemiological data on viral hepatitis in French Guiana and Suriname are available for urban areas, but not for remote communities. The Maroni River, which separates FG and Suriname, is home to Tribal and Indigenous communities. Reaching these populations is challenging due to logistical constraints, cultural and language barriers, and mistrust of outsiders. Objectives We aimed to conduct an epidemiological study of viral hepatitis [Maroni Hepatites Virales (MaHeVi)] in this remote and complex area. Here, we describe the operational hurdles and solutions required to achieve this. Methods We undertook a preliminary assessment of the area with local community leaders and health workers to gain approval of MaHeVi, acceptance of blood sampling, and suggestions for adapting the study to cultural and logistical constraints. Anthropological assessments were conducted through focus groups and interviews with key individuals to assess knowledge, beliefs and risk factors for VH. Results MaHeVi was well received by the local communities. The approval of the community leaders was crucial for the implementation and acceptance of the study. The main adaptations were hiring community health mediators to overcome cultural and language differences, using blotting paper instead of venipuncture for logistical and acceptability reasons, and adapting communication materials. Conclusion Careful preparation and tailoring of the communication materials and research protocol have enabled the successful implementation of the study. This process could be replicated in this area and transferred to other complex contexts combining borders, logistical hurdles and populations requiring cultural adaptations.
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Affiliation(s)
- Roxane Schaub
- CIC AG/Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
- UMR Tropical Biome and Immuno-pathophysiology, Université de Guyane, Cayenne, French Guiana
| | - M. Sigrid Mac Donald Ottevanger
- Foundation for Scientific Research Suriname (SWOS), Paramaribo, Suriname
- Department of Medical Microbiology, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Soeradj Harkisoen
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Béatrice Pesna
- Centres Délocalisés de Prévention et de Soins, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
| | | | | | | | - Edouard Tuaillon
- Pathogenèse et Contrôle des Infections Chroniques, INSERM U1058, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Stephen Vreden
- Foundation for Scientific Research Suriname (SWOS), Paramaribo, Suriname
| | - Mathieu Nacher
- CIC AG/Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
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Ning F, Xin L, Quan W, Xiaohui L, Xiaoping D. A preliminary research on transcultural capacity in global public health: from the view of public health professionals. BMC Public Health 2023; 23:465. [PMID: 36899364 PMCID: PMC10007795 DOI: 10.1186/s12889-023-15312-8] [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: 08/04/2022] [Accepted: 02/23/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Transcultural capacity is a key component of consolidated global public health assistance cooperation (GPHAC). The aim of this study is to investigate the transcultural capacity perceptions of public health professionals from China's disease control and prevention system after relative training in order to provide a reference for enhancing transcultural capacity during the practice of GPHAC. METHODS A cross sectional qualitative survey in which self-administrated questionnaire with 5 open ended questions was used. The questionnaire was disseminated on the completion of an online training for China's senior public health professions on transcultural capacity in GPHAC. Descriptive statistics, word frequency analysis and content analysis were used to analyze the questionnaire data. RESULTS Totally, 45 participants took part in this training, 25 of them voluntarily participated in this survey. The participants demonstrated the need for transcultural competence in public health services and suggested improvement in the course content arising from their wealth of knowledge and practical experience in the field. 96% of the participants considered that the training course was "very necessary" and "meaningful". The most interested topics were "Overview of transcultural adaptation and GPHAC", "Transcultural adaptation and response" and "African culture and health". The contents about "Country-specific analysis on cultural factors in public health", "rapid transcultural adaptation" and "more specific practical experiences in diverse cultural backgrounds" were suggested to be added in future training. The participants considered that transcultural capacity ensured the smooth progress of GPHAC and they both could complement each other, transcultural adaptation was the premise of gaining trust and reaching cooperation, it can be conducive to the health assistance professionals to integrate into local cultural life, facilitating their foreign assistance work to be effective and efficient, and impart experiences well. The participants hoped to put the concept into action. CONCLUSION The importance of transcultural competence in GPHAC is becoming a consensus of public health professionals. Enhanced transcultural competence reflected in the attitude of public health as well as other health workers would promote GPHAC and would foster efficient emergency health response management among many countries.
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Affiliation(s)
- Feng Ning
- Center for Global Public Health, Chinese Center for Disease Control and Prevention, Room 211, 155 Changbai Road, Changping District, 102206, Beijing, P. R. China
| | - Liu Xin
- Jiangsu Provincial Center for Disease Control and Prevention, 122 Maihua Road, Qixia District, 210028, Nanjing, Jiangsu Province, China
| | - Wang Quan
- School of Public Health, Wuhan University, 115 Donghu Road, Wuchang District, 430078, Wuhan, Hubei Province, P. R. China
| | - Liang Xiaohui
- School of Public Health, Wuhan University, 115 Donghu Road, Wuchang District, 430078, Wuhan, Hubei Province, P. R. China.
| | - Dong Xiaoping
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, 102206, Beijing, P. R. China.
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Chaturvedi S, Porter J, Gopalakrishna Pillai GK, Abraham L, Shankar D, Patwardhan B. India and its pluralistic health system - a new philosophy for Universal Health Coverage. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 10:100136. [PMID: 36938332 PMCID: PMC10015266 DOI: 10.1016/j.lansea.2022.100136] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023]
Abstract
In this article we attempt to put forth insights into using traditional medicine (TM) systems to achieve Universal Health Coverage (UHC). We discuss the need for reimagining India's health system and the importance of an inclusive approach for UHC. We comprehend the challenges with appropriate use of TM systems and the lessons from international experience of integrating TM systems. We highlight the pathways for better utilization of TM systems for UHC in India.
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Affiliation(s)
| | - John Porter
- Clinical Research and Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Leena Abraham
- Centre for Studies in Sociology of Education, Tata Institute of Social Sciences, Mumbai, India
| | - Darshan Shankar
- Transdisciplinary University of Health Sciences and Technology, Bengaluru, India
| | - Bhushan Patwardhan
- Centre for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
- Corresponding author. National Research Professor-AYUSH, Savitribai Phule Pune University, Pune, India 411007.
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Montoya-Sanabria SM, Hernández-Sandoval YT, Cáceres-Maldonado SA, Díaz-Barrero DC, Zapata-Matheus AM, Mejia-Pérez DL, De La Torre-Arias A, Caballero-Diaz YE, González-Uribe C, Domínguez-Torres MT, Nguyen HL, Yepes-Nuñez JJ. Community-Based Knowledge Translation Strategies for Maternal, Neonatal, and Perinatal Outcomes: A Systematic Review of Quantitative and Qualitative Data. Int J Public Health 2023; 68:1605239. [PMID: 37153698 PMCID: PMC10157638 DOI: 10.3389/ijph.2023.1605239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 03/22/2023] [Indexed: 05/10/2023] Open
Abstract
Objective: To identify and assess the effect of community-based Knowledge Translation Strategies (KTS) on maternal, neonatal, and perinatal outcomes. Methods: We conducted systematic searches in Medline, Embase, CENTRAL, CINAHL, PsycInfo, LILACS, Wholis, Web of Science, ERIC, Jstor, and Epistemonikos. We assessed the certainty of the evidence of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: We identified seven quantitative and seven qualitative studies. Quantitative findings suggest that there is a possible effect on reducing maternal mortality (RR 0.65; 95% CI, 0.48-0.87; moderate evidence certainty); neonatal mortality (RR 0.79; 95% CI 0.70-0.90; moderate evidence certainty); and perinatal mortality (RR 0.84; 95% CI 0.77-0.91; moderate evidence certainty) in women exposed to KTS compared to those who received conventional interventions or no intervention at all. Analysis of qualitative studies identified elements that allowed to generate benefit effects in improving maternal, neonatal, and perinatal outcomes. Conclusion: The KTS in maternal, neonatal, and perinatal outcomes might encourage the autonomy of communities despite that the certainty of evidence was moderate.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Juan José Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
- *Correspondence: Juan José Yepes-Nuñez,
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Mwakawanga DL, Mwilike B, Kaneko M, Shimpuku Y. Local knowledge and derived practices of safety during pregnancy, childbirth and postpartum: a qualitative study among nurse-midwives in urban eastern Tanzania. BMJ Open 2022; 12:e068216. [PMID: 36521900 PMCID: PMC9756159 DOI: 10.1136/bmjopen-2022-068216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Maternal and newborn mortality are still high in low-income and middle-income countries despite global efforts to improve the quality of care by prioritising evidence-based practices and increasing the number of births attended by skilled personnel. During childbirth, women are hesitant to use the health facility services. Concerns about safety and risks during pregnancy, childbirth and postpartum period are deeply rooted in local health practices and beliefs. OBJECTIVE The aim of this study was to explore the perceptions of local health knowledge and derived practices among nurse-midwives in urban eastern Tanzania. METHODS An exploratory qualitative study design was carried out in a district hospital in eastern Tanzania. Twenty-one nurse-midwives participated in two focus group discussions. The data were analysed using qualitative content analysis. RESULTS Based on existing scientific data, local knowledge and derived practices were categorised as potentially beneficial, neither beneficial nor harmful and potentially harmful. Our study identified a wide range of local knowledge and derived practices used by women. These include to refrain from shouting or crying to prevent exhaustion during labour, drinks and foods restrictions during labour and after birth, and use of local herbs to stimulate labour. In addition, midwives reinforced the importance of integrating local knowledge and practices with potential benefits with evidence-based practices. Encouraging and listening to women would offer an opportunity to reduce harmful practices. CONCLUSIONS While non-harmful and beneficial practices for ensuring safety during pregnancy, childbirth and postpartum period should be accepted and supported as a part of our cultural richness, harmful practices should be discouraged. This can be achieved through antenatal health education and afterbirth health messages on hospital discharge to promote positive childbirth health outcomes.
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Affiliation(s)
- Dorkasi L Mwakawanga
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Graduate School of Biomedical and Health Sciences, Department of Global Health Nursing, Hiroshima University, Hiroshima, Japan
| | - Beatrice Mwilike
- Department of Community Health Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Morie Kaneko
- Graduate School of Asian and African Area Studies, Center for African Area Studies, Kyoto University, Kyoto, Japan
| | - Yoko Shimpuku
- Graduate School of Biomedical and Health Sciences, Department of Global Health Nursing, Hiroshima University, Hiroshima, Japan
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12
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Luna P, Paredes-Ruvalcaba N, Valdes T, Guerrero B, García-Martínez A, Escamilla RP, Bueno-Gutiérrez D. Discrepancies in infant feeding recommendations between grandmothers and healthcare providers in rural Mexico. Int Breastfeed J 2022; 17:77. [PMID: 36419119 PMCID: PMC9682729 DOI: 10.1186/s13006-022-00518-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/05/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Infant feeding practices are rapidly changing within rural areas in Mexico, including indigenous communities. The aim of this study was to compare infant feeding recommendations between grandmothers and healthcare providers, to better understand the factors that may influence these practices within these communities. This study builds on research that recognizes the legacy of colonization as an ongoing process that impacts the lives of people through many pathways, including the substandard healthcare systems available to them. METHODS Qualitative study based on secondary data analysis from interviews and focus groups guided by a socioecological framework conducted in 2018 in two rural, Indigenous communities in Central Mexico. Participants were purposively selected mothers (n = 25), grandmothers (n = 11), and healthcare providers (n = 24) who offered care to children up to two years of age and/or their mothers. Data were coded and thematically analyzed to contrast the different perspectives of infant feeding recommendations and practices between mother, grandmothers, and healthcare providers. RESULTS Grandmothers and healthcare providers differed in their beliefs regarding appropriate timing to introduce non-milk foods and duration of breastfeeding. Compared to grandmothers, healthcare providers tended to believe that their recommendations were superior to those from people in the communities and expressed stereotypes reflected in negative attitudes towards mothers who did not follow their recommendations. Grandmothers often passed down advice from previous generations and their own experiences with infant feeding but were also open to learning from healthcare providers through government programs and sharing their knowledge with their daughters and other women. Given the contradictory recommendations from grandmothers and healthcare providers, mothers often were unsure which advice to follow. CONCLUSIONS There are important differences between grandmothers and healthcare providers regarding infant feeding recommendations. Healthcare providers may perceive their recommendations as superior given the neocolonial structures of the medical system. Public health policies are needed to address the different recommendations mothers receive from different sources, by harmonizing them and following an evidence-informed approach. Breastfeeding programs need to value and to seek the participation of grandmothers.
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Affiliation(s)
- Paulina Luna
- grid.47100.320000000419368710Yale University School of Medicine, New Haven, CT USA
| | - Nerli Paredes-Ruvalcaba
- grid.17088.360000 0001 2150 1785Department of Anthropology, Michigan State University, East Lansing, MI USA
| | - Tania Valdes
- grid.412187.90000 0000 9631 4901Facultad de Psicología, Universidad del Desarrollo, Santiago, Chile
| | - Barbara Guerrero
- Servicios Integrales de Atención en La Infancia, Ciudad de Mexico, México
| | - Angélica García-Martínez
- grid.131063.60000 0001 2168 0066Lucy Family Institute for Data and Society, University of Notre Dame, Notre Dame, IN USA
| | - Rafael Pérez Escamilla
- grid.47100.320000000419368710School of Public Health, Yale University, New Haven, CT USA
| | - Diana Bueno-Gutiérrez
- grid.412852.80000 0001 2192 0509Facultad de Medicina Y Psicología, Universidad Autónoma de Baja California (UABC), Tijuana, BC México
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13
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Sarmiento I, Paredes-Solís S, de Jesús García A, Maciel Paulino N, Serrano de Los Santos FR, Legorreta-Soberanis J, Zuluaga G, Cockcroft A, Andersson N. Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial. BMC Pregnancy Childbirth 2022; 22:43. [PMID: 35038990 PMCID: PMC8762841 DOI: 10.1186/s12884-021-04344-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Available research on the contribution of traditional midwifery to safe motherhood focuses on retraining and redefining traditional midwives, assuming cultural prominence of Western ways. Our objective was to test if supporting traditional midwives on their own terms increases cultural safety (respect of Indigenous traditions) without worsening maternal health outcomes. METHODS Pragmatic parallel-group cluster-randomised controlled non-inferiority trial in four municipalities in Guerrero State, southern Mexico, with Nahua, Na savi, Me'phaa and Nancue ñomndaa Indigenous groups. The study included all pregnant women in 80 communities and 30 traditional midwives in 40 intervention communities. Between July 2015 and April 2017, traditional midwives and their apprentices received a monthly stipend and support from a trained intercultural broker, and local official health personnel attended a workshop for improving attitudes towards traditional midwifery. Forty communities in two control municipalities continued with usual health services. Trained Indigenous female interviewers administered a baseline and follow-up household survey, interviewing all women who reported pregnancy or childbirth in all involved municipalities since January 2016. Primary outcomes included childbirth and neonatal complications, perinatal deaths, and postnatal complications, and secondary outcomes were traditional childbirth (at home, in vertical position, with traditional midwife and family), access and experience in Western healthcare, food intake, reduction of heavy work, and cost of health care. RESULTS Among 872 completed pregnancies, women in intervention communities had lower rates of primary outcomes (perinatal deaths or childbirth or neonatal complications) (RD -0.06 95%CI - 0.09 to - 0.02) and reported more traditional childbirths (RD 0.10 95%CI 0.02 to 0.18). Among institutional childbirths, women from intervention communities reported more traditional management of placenta (RD 0.34 95%CI 0.21 to 0.48) but also more non-traditional cold-water baths (RD 0.10 95%CI 0.02 to 0.19). Among home-based childbirths, women from intervention communities had fewer postpartum complications (RD -0.12 95%CI - 0.27 to 0.01). CONCLUSIONS Supporting traditional midwifery increased culturally safe childbirth without worsening health outcomes. The fixed population size restricted our confidence for inference of non-inferiority for mortality outcomes. Traditional midwifery could contribute to safer birth among Indigenous communities if, instead of attempting to replace traditional practices, health authorities promoted intercultural dialogue. TRIAL REGISTRATION Retrospectively registered ISRCTN12397283 . Trial status: concluded.
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Affiliation(s)
- Iván Sarmiento
- CIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges 3rd floor, Montreal, QC, H3S 1Z1, Canada. .,Grupo de Estudios en Sistemas Tradicionales de Salud, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia.
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Abraham de Jesús García
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Nadia Maciel Paulino
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | | | - José Legorreta-Soberanis
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Germán Zuluaga
- Grupo de Estudios en Sistemas Tradicionales de Salud, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Anne Cockcroft
- CIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges 3rd floor, Montreal, QC, H3S 1Z1, Canada
| | - Neil Andersson
- CIET-Participatory Research at McGill, Faculty of Medicine and Health Sciences, Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges 3rd floor, Montreal, QC, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Mexico
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Pant I, Khosla S, Lama JT, Shanker V, AlKhaldi M, El-Basuoni A, Michel B, Bitar K, Nsofor IM. Decolonising global health evaluation: Synthesis from a scoping review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000306. [PMID: 36962490 PMCID: PMC10021742 DOI: 10.1371/journal.pgph.0000306] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/14/2022] [Indexed: 11/17/2022]
Abstract
As decolonisation awareness and activism amplifies in the mainstream masses and within academic realms across a variety of fields, the time is right to converge parallel movements to decolonise the fields of global health and evaluation by restructuring relations of dependency and domination reified through the "foreign gaze"1 or "white gaze." We conducted a review of relevant records with the following inclusion criteria-they define or advocate for the decolonisation of global health evaluation or explicate methods, policies or interventions to decolonise global health evaluation published by advocates of the decolonisation movement from both fields. These records were derived following a systematic article search by the lead autthor on Google, Google Scholar, NewsBank, and PubMed using the following keywords: "decolonising" and "global health," "evaluation," or "global health evaluation" replicating a digital search strategy utilized by scoping reviews across a variety of topics. Because the topic of interest is nascent and still emerging, the date range was not restricted. The lead author screened abstracts retrieved from the search. In total, 57 records, ranging in publication date from 1994 to 2020, were selected and charted for this review. We reviewed these records to identify socio-ecological factors that influence the decolonisation of global health evaluation, such as decolonising minds; reorienting funders and reforming funding mechanisms; and investing in sustainable capacity exchange. In doing so, we reflected on our positionality as well as our internalisation and potential reinforcement of colonial relations in the process of reporting our results. In the context of turmoil and transition due to the COVID-19 pandemic, our scoping review offers a starting point to embark on a journey first to transform and decolonise global health evaluation and then to achieve the greater goal of equity and justice.
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Affiliation(s)
- Ichhya Pant
- Department of Prevention and Community Health, George Washington University School of Public Health, Washington, DC, United States of America
| | - Sonal Khosla
- Independent Evaluation Scholar and Practitioner, Vancouver, British Columbia, Canada
| | - Jasmine Tenpa Lama
- Department of Pharmacology & Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Vidhya Shanker
- Interdependent Evaluation Scholar and Practitioner, Minneapolis, Minnesota, United States of America
| | - Mohammed AlKhaldi
- Faculty of Medicine and Health Sciences, McGill University Health Center (MUHC), McGill University, Montreal, QC, Canada
- Canadian Institutes of Health Research (CIHR), Health Systems Impact Fellowship, Ottawa, Canada
- Canadian Institutes of Health Research (CIHR), Health Systems Impact Fellowship, Ottawa, Canada
- Department of Environmental Health Sciences, Faculty of Communication, Arts and Sciences, Canadian University Dubai (CUD), Dubai, United Arab Emirates
- University of Basel, Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- Council on Health Research for Development (COHRED), Research Fairness Initiative, Geneva, Switzerland
| | | | - Beth Michel
- Indigenous Evaluator and Public Health Practitioner, Office of Undergraduate Admissions, Emory University, Atlanta, GA, United States of America
| | - Khalil Bitar
- Khalil Bitar, Wyss Academy for Nature, University of Bern, Bern, Switzerland
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Sarmiento I, Paredes-Solís S, Dion A, Silver H, Vargas E, Cruz P, Pimentel J, Zuluaga G, Cockcroft A, Andersson N. Maternal health and Indigenous traditional midwives in southern Mexico: contextualisation of a scoping review. BMJ Open 2021; 11:e054542. [PMID: 34949629 PMCID: PMC8710897 DOI: 10.1136/bmjopen-2021-054542] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/19/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Collate published evidence of factors that affect maternal health in Indigenous communities and contextualise the findings with stakeholder perspectives in the Mexican State of Guerrero. DESIGN Scoping review and stakeholder fuzzy cognitive mapping. INCLUSION AND EXCLUSION The scoping review included empirical studies (quantitative, qualitative or mixed methods) that addressed maternal health issues among Indigenous communities in the Americas and reported on the role or influence of traditional midwives before June 2020. The contextualisation drew on two previous studies of traditional midwife and researcher perspectives in southern Mexico. RESULTS The initial search identified 4461 references. Of 87 selected studies, 63 came from Guatemala and Mexico. Three small randomised trials involved traditional midwives. One addressed the practice of traditional midwifery. With diverse approaches to cultural differences, the studies used contrasting definitions of traditional midwives. A fuzzy cognitive map graphically summarised the influences identified in the scoping review. When we compared the literature's map with those from 29 traditional midwives in Guerrero and eight international researchers, the three sources coincided in the importance of self-care practices, rituals and traditional midwifery. The primary concern reflected in the scoping review was access to Western healthcare, followed by maternal health outcomes. For traditional midwives, the availability of hospital or health centre in the community was less relevant and had negative effects on other protective influences, while researchers conditioned its importance to its levels of cultural safety. Traditional midwives highlighted the role of violence against women, male involvement and traditional diseases. CONCLUSIONS The literature and stakeholder maps showed maternal health resulting from complex interacting factors in which promotion of cultural practices was compatible with a protective effect on Indigenous maternal health. Future research challenges include traditional concepts of diseases and the impact on maternal health of gender norms, self-care practices and authentic traditional midwifery.
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Affiliation(s)
- Iván Sarmiento
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales - CIET, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
| | - Anna Dion
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Hilah Silver
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Emily Vargas
- Unidad de Posgrados e Investigación, Universidad Autónoma de Yucatán, Merida, Yucatán, México
| | - Paloma Cruz
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Juan Pimentel
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
- Facultad de Medicina, Universidad de La Sabana, Chia, Colombia
| | - Germán Zuluaga
- Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Anne Cockcroft
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
| | - Neil Andersson
- Department of Family Medicine, McGill University, Montreal, Québec, Canada
- Centro de Investigación de Enfermedades Tropicales - CIET, Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico
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Kyoon Achan G, Eni R, Kinew KA, Phillips-Beck W, Lavoie JG, Katz A. The Two Great Healing Traditions: Issues, Opportunities, and Recommendations for an Integrated First Nations Healthcare System in Canada. Health Syst Reform 2021; 7:e1943814. [PMID: 34375567 DOI: 10.1080/23288604.2021.1943814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The First Nations in Manitoba, Canada, are calling for active recognition and incorporation of holistic traditional healing and medicine ways and approaches by the mainstream healthcare system that has hitherto tended to ignore all but biomedical approaches. This request for recognition requires elaboration on areas of opportunity for collaboration that could positively influence both Indigenous and allopathic medicine. We discuss pathways to an integrated healthcare system as community-based primary healthcare transformation. A community-based participatory research approach was used to engage eight Manitoba First Nations communities. One hundred and eighty-three (183) in-depth, semi-structured key informant interviews were completed in all communities. Grounded theory guided data analysis using NVivo 10 software. We learned that increased recognition and incorporation of traditional healing and medical methods would enhance a newly envisioned funded health system. Elders and healers will be meaningfully involved in the delivery of community-based primary health care. Funding for traditional healing and medicines are necessary components of primary health care. An overall respect for Indigenous health knowledge would aid transformation in community-based primary health care. Recognition of and respect for traditional healing, healers, medicines, therapies, and approaches is also recommended as part of addressing the legacy and intergenerational impact of assimilative policies including Indian residential schools as the Truth and Reconciliation Commission of Canada has stated in its Calls to Action.
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Affiliation(s)
- Grace Kyoon Achan
- Children's Hospital Research Institute of Manitoba & Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rachel Eni
- Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Snuneymuxw First Nation, Nanaimo, British Columbia, Canada
| | - Kathi Avery Kinew
- First Nation Health and Social Secretariat Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Phillips-Beck
- First Nation Health and Social Secretariat Manitoba, Winnipeg, Manitoba, Canada
| | - Josée G Lavoie
- Ongomiizwin- Indigenous Institute of Health and Healing, Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- Manitoba Centre for Health Policy/Max Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada
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Mudonhi N, Nunu WN. Traditional Practitioners and Nurses' Perspectives on Traditional Medicine Utilisation During Antenatal Care in Matabeleland South Province, Zimbabwe. Health Serv Insights 2021; 14:11786329211034462. [PMID: 34366673 PMCID: PMC8299876 DOI: 10.1177/11786329211034462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 07/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Traditional Health System has been reported to be the most accessible, affordable, and acceptable in resource-poor settings, particularly in Sub-Saharan Africa. It is utilised for different health needs, including pregnancy management. This study sought to explore traditional and Nurses’ perspectives on traditional medicine utilisation during antenatal care in Bulilima District, Plumtree, Zimbabwe. Methods: A qualitative survey was conducted on purposively selected nurses’ and snowballed traditional health practitioners who responded to unstructured interviews. Data were collected using a digital tape recorder, transcribed, and thematically analysed on Max Qualitative Data Analysis. Results: A total of 6 superordinate and 10 subordinate themes emerged from the collected and analysed data on both traditional practitioners and nurses. The superordinate themes associated with Traditional Medicine utilisation during pregnancy by women were: protective role, beliefs, shortening of labour, cleansing, accessibility, and collaboration between traditional practitioners and modern health practitioners. Nurses expressed their skepticism on the safety and efficacy of traditional medicine utilisation during pregnancy. Conclusion: Women utilise traditional medicines and remedies during pregnancy for different reasons, such as protection from evil spirits, foetus growth and shortening labour. There are concerns regarding their safety from the health service providers, although traditional practitioners share a different view. There is a need for investing in research that would ascertain the safety of these traditional medicines as this system has been a cheaper alternative for those who cannot afford or access modern health services.
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Affiliation(s)
- Nicholas Mudonhi
- Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Wilfred Njabulo Nunu
- Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Bulawayo, Zimbabwe.,Scientific Agriculture and Environment Development Institute, Bulawayo, Zimbabwe
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Redvers N. Patient-Planetary Health Co-benefit Prescribing: Emerging Considerations for Health Policy and Health Professional Practice. Front Public Health 2021; 9:678545. [PMID: 33996734 PMCID: PMC8119779 DOI: 10.3389/fpubh.2021.678545] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/08/2021] [Indexed: 11/16/2022] Open
Abstract
In addition to the importance of fostering and developing measures for better health-system resilience globally from the effects of climate change, there have been increasing calls for health professionals, as well as public health and medical education systems, to become partners in climate change mitigation efforts. Direct clinical practice considerations, however, have not been adequately fostered equitably across all regions with an often-confusing array of practice areas within planetary health and sustainable healthcare. This article calls for a more coordinated effort within clinical practice spaces given the urgency of global environmental change, while also taking lessons from Indigenous traditional knowledge systems—a viewpoint that is rarely heard from or prioritized in public health or medicine. Simpler and more coordinated messaging in efforts to improve patient and planetary health are needed. The creation of unifying terminology within planetary health-rooted clinical and public health practice has been proposed with the potential to bring forth dialogue between and within disciplinary offshoots and public health advocacy efforts, and within clinical and health-system policy spaces.
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Affiliation(s)
- Nicole Redvers
- Department of Family & Community Medicine, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States.,Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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