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 ID: 745819
Download Presentation The PPT/PDF document "TRADITIONAL, COMPLEMENTARY AND ALTERNATI..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
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, GhanaSlide2
OUTLINE OF PRESENTATION
INTRODUCTION
THE PROBLEM
RESEARCH QUESTIONS
OBJECTIVES OF THE STUDY
HYPOTHESES
METHODS
RESULTS AND DISCUSSION
CONCLUTION AND RECOMMENDATIONS
REFERENCESSlide3
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).
Slide4
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.Slide5
THE PROBLEM
A
mongst the top ten diseases,
m
alaria 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
).
E
fficacy
and potency of
TCAM is justified and attracting
global attention
(WHO, 2010; Gyasi
et al
,
2011)
Slide6
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.Slide7
RESEARCH QUESTIONS
W
hat
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?Slide8
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
p
refecture.Slide9
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 useSlide10
DATA AND METHODS
Study
Design
C
ross-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.Slide11
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
.Slide12
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).Slide13
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.Slide14
RESULTS AND DISCUSSION
Characteristics
of the study
sample
Age
Sex
Education
Employment
Monthly IncomeSlide15
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
FREQUENCY (N)
PER CENT (%)
TRADITIONAL
HOSPITAL
39
20.6
ORTHODOX HOSPITAL
94
49.7
COMBINATION
OF CARE
54
29.7
TOTAL
189
100.0Slide16
RESULTS AND DISCUSSION CONT’D
Care seeking at TCAM healer and Use of
TCAM
Table3:
Care seeking at TCAM healer
Use of
TCAM
YES
NO
TOTAL
YES
52 (27.5)
9 (4.8)
61
Care Given
at TCAM Healer
NO
32 (16.9)
96 (50.8)
128
TOTAL
84
105
189Slide17
RESULTS AND DISCUSSION CONT’D
Factors associated with TCAM use
Table 4:
VARIABLE
CO-EFFICIENT
SIGNIFICANCE
(P-VALUE)
Affordability
0.491
0.006
Side effects
0.241
0.009
Effectiveness of TCAM
0.200
0.032
Availability
0.210
0.034
Adjusted Regression Squared (R
2
)
0.743Slide18
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
flu-like 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’’.Slide19
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’’.Slide20
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. Slide21
CONCLUSION AND RECOMMENDATION
Knowledge about malaria and its treatment.
There is a need to continue documenting traditional treatments of malaria
in
G
hana
before they are lost.
It is recommended that studies to standardize doses should be carried out.
Make
TCAM
part of the public health systemSlide22
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.
Slide23
THANK YOU FOR
COMING