The Determinants of Traditional Medicine Use in Northern Tanzania: A Mixed-Methods Study
Identifieur interne : 001355 ( Main/Exploration ); précédent : 001354; suivant : 001356The Determinants of Traditional Medicine Use in Northern Tanzania: A Mixed-Methods Study
Auteurs : John W. Stanifer [États-Unis] ; Uptal D. Patel [États-Unis] ; Francis Karia [Tanzanie] ; Nathan Thielman [États-Unis] ; Venance Maro [Tanzanie] ; Dionis Shimbi [Tanzanie] ; Humphrey Kilaweh [Tanzanie] ; Matayo Lazaro [Tanzanie] ; Oliver Matemu [Tanzanie] ; Justin Omolo [Tanzanie] ; David Boyd [États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2015.
Abstract
Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and roles, including from a biomedical perspective. Therefore, we conducted a mixed-method study in Northern Tanzania in order to characterize the extent of and reasons for the use of traditional medicines among the general population so that we can better inform public health efforts in the region.
Between December 2013 and June 2014 in Kilimanjaro, Tanzania, we conducted 5 focus group discussions and 27 in-depth interviews of key informants. The data from these sessions were analyzed using an inductive framework method with cultural insider-outsider coding. From these results, we developed a structured survey designed to test different aspects of traditional medicine use and administered it to a random sample of 655 adults from the community. The results were triangulated to explore converging and diverging themes.
Most structured survey participants (68%) reported knowing someone who frequently used traditional medicines, and the majority (56%) reported using them themselves in the previous year. The most common uses were for symptomatic ailments (42%), chronic diseases (15%), reproductive problems (11%), and malaria/febrile illnesses (11%). We identified five major determinants for traditional medicine use in Northern Tanzania: biomedical healthcare delivery, credibility of traditional practices, strong cultural identities, individual health status, and disease understanding.
In order to better formulate effective local disease management programs that are sensitive to TM practices, we described the determinants of TM use. Additionally, we found TM use to be high in Northern Tanzania and that its use is not limited to lower-income areas or rural settings. After symptomatic ailments, chronic diseases were reported as the most common reason for TM use which may be particularly important in Northern Tanzania where non-communicable diseases are a rapidly growing burden.
Url:
DOI: 10.1371/journal.pone.0122638
PubMed: 25848762
PubMed Central: 4388565
Affiliations:
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xml:lang="fr">Tanzanie</country><wicri:regionArea>Kilimanjaro Christian Medical College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Kilaweh, Humphrey" sort="Kilaweh, Humphrey" uniqKey="Kilaweh H" first="Humphrey" last="Kilaweh">Humphrey Kilaweh</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Kilimanjaro Christian Medical College, Moshi, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Kilimanjaro Christian Medical College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Lazaro, Matayo" sort="Lazaro, Matayo" uniqKey="Lazaro M" first="Matayo" last="Lazaro">Matayo Lazaro</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Kilimanjaro Christian Medical College, Moshi, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Kilimanjaro Christian Medical College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Matemu, Oliver" sort="Matemu, Oliver" uniqKey="Matemu O" first="Oliver" last="Matemu">Oliver Matemu</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Kilimanjaro Christian Medical College, Moshi, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Kilimanjaro Christian Medical College, Moshi</wicri:regionArea><wicri:noRegion>Moshi</wicri:noRegion></affiliation></author><author><name sortKey="Omolo, Justin" sort="Omolo, Justin" uniqKey="Omolo J" first="Justin" last="Omolo">Justin Omolo</name><affiliation wicri:level="1"><nlm:aff id="aff005"><addr-line>Tanga AIDS Working Group, Tanga, Tanzania</addr-line></nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Tanga AIDS Working Group, Tanga</wicri:regionArea><wicri:noRegion>Tanga</wicri:noRegion></affiliation></author><author><name sortKey="Boyd, David" sort="Boyd, David" uniqKey="Boyd D" first="David" last="Boyd">David Boyd</name><affiliation wicri:level="2"><nlm:aff id="aff002"><addr-line>Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Duke Global Health Institute, Duke University, Durham, North Carolina</wicri:regionArea><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Introduction</title><p>Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and roles, including from a biomedical perspective. Therefore, we conducted a mixed-method study in Northern Tanzania in order to characterize the extent of and reasons for the use of traditional medicines among the general population so that we can better inform public health efforts in the region.</p></sec><sec id="sec002"><title>Methods</title><p>Between December 2013 and June 2014 in Kilimanjaro, Tanzania, we conducted 5 focus group discussions and 27 in-depth interviews of key informants. The data from these sessions were analyzed using an inductive framework method with cultural insider-outsider coding. From these results, we developed a structured survey designed to test different aspects of traditional medicine use and administered it to a random sample of 655 adults from the community. The results were triangulated to explore converging and diverging themes.</p></sec><sec id="sec003"><title>Results</title><p>Most structured survey participants (68%) reported knowing someone who frequently used traditional medicines, and the majority (56%) reported using them themselves in the previous year. The most common uses were for symptomatic ailments (42%), chronic diseases (15%), reproductive problems (11%), and malaria/febrile illnesses (11%). We identified five major determinants for traditional medicine use in Northern Tanzania: biomedical healthcare delivery, credibility of traditional practices, strong cultural identities, individual health status, and disease understanding.</p></sec><sec id="sec004"><title>Conclusions</title><p>In order to better formulate effective local disease management programs that are sensitive to TM practices, we described the determinants of TM use. Additionally, we found TM use to be high in Northern Tanzania and that its use is not limited to lower-income areas or rural settings. After symptomatic ailments, chronic diseases were reported as the most common reason for TM use which may be particularly important in Northern Tanzania where non-communicable diseases are a rapidly growing burden.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Bodeker, G" uniqKey="Bodeker G">G Bodeker</name></author><author><name sortKey="Carter, G" uniqKey="Carter G">G Carter</name></author><author><name sortKey="Burford, G" uniqKey="Burford G">G Burford</name></author><author><name sortKey="Dvorak Little, M" uniqKey="Dvorak Little M">M Dvorak-Little</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Mhame, Pp" uniqKey="Mhame P">PP Mhame</name></author><author><name sortKey="Busia, K" uniqKey="Busia K">K Busia</name></author><author><name sortKey="Kasilo, Mj" uniqKey="Kasilo M">MJ 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Tolan</name></author><author><name sortKey="Helmke, N" uniqKey="Helmke N">N Helmke</name></author><author><name sortKey="Mukerjee, R" uniqKey="Mukerjee R">R Mukerjee</name></author><author><name sortKey="Naicker, S" uniqKey="Naicker S">S Naicker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mbanya, Jc" uniqKey="Mbanya J">JC Mbanya</name></author><author><name sortKey="Motala, Aa" uniqKey="Motala A">AA Motala</name></author><author><name sortKey="Sobngwi, E" uniqKey="Sobngwi E">E Sobngwi</name></author><author><name sortKey="Assah, F" uniqKey="Assah F">F Assah</name></author><author><name sortKey="Enoru, St" uniqKey="Enoru S">ST Enoru</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hendriks, Me" uniqKey="Hendriks M">ME Hendriks</name></author><author><name sortKey="Wit, F" uniqKey="Wit F">F Wit</name></author><author><name sortKey="Roos, Mtl" uniqKey="Roos M">MTL Roos</name></author><author><name sortKey="Brewster, Lm" uniqKey="Brewster L">LM Brewster</name></author><author><name sortKey="Akande, Tm" uniqKey="Akande T">TM Akande</name></author><author><name sortKey="De Beer, Ih" uniqKey="De Beer I">IH de Beer</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Tanzanie</li><li>États-Unis</li></country><region><li>Caroline du Nord</li></region></list><tree><country name="États-Unis"><region name="Caroline du Nord"><name sortKey="Stanifer, John W" sort="Stanifer, John W" uniqKey="Stanifer J" first="John W." last="Stanifer">John W. Stanifer</name></region><name sortKey="Boyd, David" sort="Boyd, David" uniqKey="Boyd D" first="David" last="Boyd">David Boyd</name><name sortKey="Patel, Uptal D" sort="Patel, Uptal D" uniqKey="Patel U" first="Uptal D." last="Patel">Uptal D. Patel</name><name sortKey="Patel, Uptal D" sort="Patel, Uptal D" uniqKey="Patel U" first="Uptal D." last="Patel">Uptal D. Patel</name><name sortKey="Stanifer, John W" sort="Stanifer, John W" uniqKey="Stanifer J" first="John W." last="Stanifer">John W. Stanifer</name><name sortKey="Thielman, Nathan" sort="Thielman, Nathan" uniqKey="Thielman N" first="Nathan" last="Thielman">Nathan Thielman</name><name sortKey="Thielman, Nathan" sort="Thielman, Nathan" uniqKey="Thielman N" first="Nathan" last="Thielman">Nathan Thielman</name></country><country name="Tanzanie"><noRegion><name sortKey="Karia, Francis" sort="Karia, Francis" uniqKey="Karia F" first="Francis" last="Karia">Francis Karia</name></noRegion><name sortKey="Kilaweh, Humphrey" sort="Kilaweh, Humphrey" uniqKey="Kilaweh H" first="Humphrey" last="Kilaweh">Humphrey Kilaweh</name><name sortKey="Lazaro, Matayo" sort="Lazaro, Matayo" uniqKey="Lazaro M" first="Matayo" last="Lazaro">Matayo Lazaro</name><name sortKey="Maro, Venance" sort="Maro, Venance" uniqKey="Maro V" first="Venance" last="Maro">Venance Maro</name><name sortKey="Matemu, Oliver" sort="Matemu, Oliver" uniqKey="Matemu O" first="Oliver" last="Matemu">Oliver Matemu</name><name sortKey="Omolo, Justin" sort="Omolo, Justin" uniqKey="Omolo J" first="Justin" last="Omolo">Justin Omolo</name><name sortKey="Shimbi, Dionis" sort="Shimbi, Dionis" uniqKey="Shimbi D" first="Dionis" last="Shimbi">Dionis Shimbi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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