“I don’t know anything about their Culture”: The Disconnect between Allopathic and Traditional Maternity Care Providers in Rural Northern Ghana

Elizabeth Hill, Rebecca Hess, Raymond Aborigo, Philip Adongo, Abraham Hodgson, Cyril Engmann, Cheryl A. Moyer

Abstract

The provision of maternal and neonatal health care in rural northern Ghana is pluralistic, consisting of traditional and allopathic providers. Although women often use these providers interchangeably, important differences exist.  This study explored the differences in approaches to maternal and neonatal care provision by these two different types of providers. This research was part of the Stillbirth and Neonatal Death Study (SANDS), conducted in northern Ghana in 2010. Trained field staff of the Navrongo Health Research Centre conducted in-depth interviews with 13 allopathic and 8 traditional providers. Interviews were audio-recorded, transcribed, and analyzed using in vivo coding and discussion amongst the research team. Three overarching themes resulted: 1) many allopathic providers were isolated from the culture of the communities in which they practiced, while traditional providers were much more aware of the local cultural beliefs and practices. 2) Allopathic and traditional healthcare providers have different frameworks for understanding health and disease, with allopathic providers relying heavily on their biomedical knowledge, and traditional providers drawing on their knowledge of natural remedies. 3) All providers agreed that education directed at pregnant women, providers (both allopathic and traditional), and the community at large is needed to improve maternal and neonatal outcomes. Our findings suggest that, among other things, programmatic efforts need to be placed on the cultural education of allopathic providers. (Afr J Reprod Health 2014; 18[2]: 36-45).

 

Keywords: Allopathic medicine, traditional medicine, maternal health, delivery care, culture

 

Résumé

 

La prestation de soins de santé maternelle et néonatale dans les régions rurales du nord du Ghana est pluraliste, composé de fournisseurs traditionnels et allopathiques. Bien que les femmes utilisent souvent ces fournisseurs interchangeables, il existe des différences importantes. Cette étude a exploré les différences dans les approches à la prestation de soins de santé maternelle et néonatale par ces deux types de fournisseurs différents. Cette recherche fait partie des études sur la mortinatalité et les décès néonatales (EMDN), menées dans le nord du Ghana en 2010. Le personnel de terrain formé du Centre de Recherche en santé de Navrongo a mené des entrevues en profondeur avec 13 allopathique et 8 fournisseurs traditionnels. Les entrevues ont été enregistrées sur bande audio, transcrites, et analysées à l'aide du codage in vivo et la discussion entre l'équipe de recherche. Trois grands thèmes ont été constatés : 1) De nombreux fournisseurs allopathiques ont été isolés à partir de la culture des communautés dans lesquelles ils pratiquaient, tandis que les fournisseurs traditionnels étaient beaucoup plus conscients des croyances et des pratiques culturelles locales. 2) les fournisseurs allopathiques et traditionnels de soins de santé  ont des cadres différents pour la compréhension de la santé et de la maladie, alors que les fournisseurs allopathiques s'appuient fortement sur leur connaissance biomédicale,  les fournisseurs traditionnels  s'appuient sur leur connaissance des remèdes naturels. 3) Tous les fournisseurs sont d’accord  que l'éducation qui vise les femmes enceintes, les fournisseurs (allopathiques et traditionnels), et la communauté au sens large, est nécessaire pour améliorer la santé maternelle et néonatale. Nos résultats suggèrent que, entre autres, les efforts programmatiques doivent être appliqués à l'éducation culturelle des fournisseurs allopathiques. Afr J Reprod Health 2014; 18[2]: 36-45).

 

Mots-clés: médecine allopathique,  médecine traditionnelle,  santé maternelle, soins de l’accouchement, culture

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