Transcript TRADITIONAL, COMPLEMENTARY AND ALTERNATIVE …

TRADITIONAL, COMPLEMENTARY AND
ALTERNATIVE MEDICINE IN THE
MANAGEMENT OF MALARIA IN THE
URBAN-PERIPHERY, GHANA
By
RAZAK M. GYASI AND CHARLOTTE M. MENSAH
DEPARTMENT OF GEOGRAPHY AND RURAL DEVELOPMENT, KNUST, KUMASI
GGA Annual Conference, August, 2012, KNUST, Kumasi, Ghana
OUTLINE OF PRESENTATION
 INTRODUCTION
 THE PROBLEM
 RESEARCH QUESTIONS
 OBJECTIVES OF THE STUDY
 HYPOTHESES
 METHODS
 RESULTS AND DISCUSSION
 CONCLUTION AND RECOMMENDATIONS
 REFERENCES
INTRODUCTION
 Malaria affects 350 to 500 million of the
world’s population (Souares et al, 2008).
 Causes 90% of 1 to 2.5 million deaths
annually in Africa (WHO/UNICEF, 2007).
 In Ghana, 3.5 million clinical cases of malaria
are reported annually. accounts for over 38%
of all deaths in children (MoH, 2006).
INTRO CONT’D
 Malaria leads to loss of productivity
(Assenso-Okyere and Asante, 2003)
 Malaria causes absenteeism in school
children in Ghana (WHO/UNICEF, 2003).
 Causes poverty and pressure on the scanty
orthodox health facilities.
THE PROBLEM
 Amongst the top ten diseases, malaria accounted for
41.4% in 2009, 38. 6% in 2010 and 50.5% in 2011 (Kwabre
East District Health Directorate, 2011).
 Apart from side effects of use of orthodox medicine,
malaria control/eradication is under constant threat
(Mendis et al, 2009; Orwa, 2007).
 ACTs have failed in Cambodia, China, Myanmar and
Vietnam (Dondrop et al, 2009; Beisel, 2010).
 Efficacy and potency of TCAM is justified and attracting
global attention (WHO, 2010; Gyasi et al, 2011)
THE PROBLEM CONT’D
 60% of children with malaria was treated with
TCAM in Ghana, Mali, Nigeria and Zambia
(WHO, 2001).
 70% of Ghanaians depend on TCAM but the
frequency of use is ravel in Kwabre East District
(MoH/DHA, 2011).
 Correlates of TCAM use is mixed and implicit.
RESEARCH QUESTIONS
What is the frequency of use of TCAM among
malaria patients in the study communities?
What are the factors associated with the use
of TCAM among malaria subjects?
 What is the knowledge and practice of TCAM
healers in managing malaria?
STUDY OBJECTIVES
 To investigate the frequency of use of TCAM
among malaria subjects in Kwabre East District.
 To examine the factors that influence TCAM use
among malaria patients.
 To analyze the knowledge and practices of
TCAM practitioners in the management of
malaria in the study prefecture.
HYPOTHESES
 The study was guided by the hypotheses that:
 Higher educational level of malaria patients is not
associated with TCAM use.
 Efficacy of TCAM does not correlate with the use of TCAM.
 The use of TCAM is not associated with its side effects.
 Cost effectiveness does not show significance to TCAM
use
DATA AND METHODS
 Study Design
 Cross-sectional survey (Buor, 2004).
 Mixed or triangulation approaches (Trochim, 2006;
Mack et al, 2005; Cohen and Manion, 2000; Altrichter
et al., 2008).
 The Variable
 Dependent variable: use of TCAM.
 Independent variables: age, sex, income, cost,
education, belief, efficacy, availability, side effects,
marital status, residential status.
DATA AND METHODS CONT’D
 Sampling
 Study Area: Kwabre East District of Ashanti
 Selected Study Prefecture: Mamponteng,
Aboaso, Ntonso, Antoa, Kenyasi, Brofoyedu,
Abira, Bosore and Abirem.
DATA AND METHODS CONT’D
 Sources of Data: 2 sets of primary data and Secondary
information from archives & documents.
 Study Sample & Size: 189 Malaria Victims and 5 TCAM
Practitioners of malaria.
 Sampling Technique: Systematic random sampling &
Snowball techniques.
 Data Collection Tools: Questionnaire/structured
interviews (for Quantitative data) & In-depth interviews
(for Qualitative data).
DATA AND METHODS CONT’D
Data Analysis:
 Quantitative: Stepwise Linear regression
technique via PASW v.17.0; Cross-tabulations;
Percentages and frequency tables.
Significance: @ ≤ 0.05.
 Qualitative: Content analysis via themes &
direct quotes.
RESULTS AND DISCUSSION
 Characteristics of the study sample
 Age
 Sex
 Education
 Employment
 Monthly Income
RESULTS AND DISCUSSION CONT’D
 Health care seeking and Frequency of use of TCAM
Table 2: Health Seeking and treatment modality for malaria victims.
CATEGORY
TRADITIONAL
HOSPITAL
ORTHODOX
HOSPITAL
COMBINATION
OF CARE
TOTAL
FREQUENCY (N) PER CENT (%)
39
20.6
94
49.7
54
29.7
189
100.0
RESULTS AND DISCUSSION CONT’D
 Care seeking at TCAM healer and Use of TCAM
Table3: Care seeking at TCAM healer
Care Given
at TCAM Healer
Use of
TCAM
YES
NO
TOTAL
YES
52 (27.5)
9 (4.8)
61
NO
32 (16.9) 96 (50.8)
TOTAL
84
105
128
189
RESULTS AND DISCUSSION CONT’D
 Factors associated with TCAM use
Table 4:
VARIABLE
Affordability
0.491
SIGNIFICANCE
(P-VALUE)
0.006
Side effects
0.241
0.009
Effectiveness of
TCAM
Availability
0.200
0.032
0.210
0.034
Adjusted
Regression
Squared (R2)
CO-EFFICIENT
0.743
RESULTS AND DISCUSSION CONT’D
The perspective of TCAM practitioners related to
causes and prevalence of malaria
 ‘‘The owners of ‘‘atiridii’’ (malaria) are mosquitoes and they
distribute it freely to anybody they meet anywhere through bites. The
disease also do not respect anybody as it can affect males and
females alike especially women who are pregnant and children’’.
 ‘‘Malaria is not just like any other disease. It can invite all sort of
fever on you and easily makes you very weak. It makes one have flulike symptoms, severe headache and vomit, increase body
temperature and cannot eat any food. In children, malaria easily
brings about convulsion which kills them thereafter. Although,
HIV/AIDS is dangerous, malaria can kill better if it is not treated early
and with proper approach. Malaria always moves with its casket and
carries whoever it meets’’.
RESULTS AND DISCUSSION CONT’D
 TCAM practitioners’ experiences and practices in the
management of malaria
 ‘‘I started treating malaria when I was only 18 after the
death of my father from whom I got trained. People from
far and near come for medicine and they come back to
tell me they are cured’’.
 Most of malaria medicines are obtained from plants. I
combine herbs, roots of plants, bark of plants, lime, etc.
The medicines are put into bottles while others are
prepared in the form of concoction and decoction. Plants
such as ‘dua kankan’, ‘nunum’, ‘iba’, ‘ankodie’, ginger,
garlic, etc are used to prepare malaria medicines’’.
RESULTS AND DISCUSSION CONT’D
 Attitude of TCAM healers and reasons that malaria victims seek
TCAM

“Majority of them come to us when they are sick and cannot afford to go to
hospital. They prefer coming to us because we are easy to reach”.
 “A patient might not be able to offer initial and prompt payment for the
medicines we give them. If they don’t have money, we give them medicine so
that they come back to pay later, probably after they get well”.
 “It is very difficult seeing a doctor at hospital. A patient has to queue for a
long time, sometimes till the evening. So it is better they come to us for
treatment”.
 “Our customers are comfortable with our system of treatment; some people
are terrified the sight of the doctor and his tools and technique of medication,
viz. injections”. Hence, they come to us.
CONCLUSION AND RECOMMENDATION
 Knowledge about malaria and its treatment.
 There is a need to continue documenting
traditional treatments of malaria in Ghana
before they are lost.
 It is recommended that studies to standardize
doses should be carried out.
 Make TCAM part of the public health system
REFERENCES

Furnham, A and Forey, J (1994) The attitudes, behaviors, and beliefs of patients of conventional vs
complementary alternative medicine. J Clin Psychol, 50:458-469.

Gyasi, R. M., Mensah, C. M., Adjei, P. O and Agyemang, S (2011) Public Perceptions of the Role of Traditional
Medicine in the Health Care Delivery System in Ghana. Global Journal of Health Science: Vol. 3, No. 2;
doi:10.5539/gjhs.v3n2p40.

Osamor, P. E and Owumi, B. E (2010) Contemporary and alternative medicine in the management of
hypertension in an urban Nigerian community. BMC Complementary and Alternative Medicine, 10:36
http://www.biomedcentral.com/1472-6882/10/36

Orwa, J. A., Mwitari, P. G., Matu, E. N., and Rukunga, G. M. (2007) Traditional Healers and the Management
of Malaria in Kisumu Disrict, Kenya.East African Medical Journal; Vol 84 No: 2

UNICEF (2007) Malaria and children: Progress in intervention coverage. The United Nations Children’s Fund
(UNICEF)

Vincent, C and Furnham, A (1996) Why do patients turn to complementary medicine? An
empirical study. Br J Clin Psychol, 35:37-48.
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