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- Convenors:
-
Albert Roca
(University of Lleida)
Pino Schirripa (University of Messina)
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- Stream:
- Health
- Location:
- Gordon Aikman Lecture Theatre
- Sessions:
- Wednesday 12 June, -
Time zone: Europe/London
Short Abstract:
The panel invites to discuss the significance and quality of usual health indicators (as life expectancy or blood pressure) in Africa in relation to eventual proposals for describing and measuring local knowledge in order to test the relation between plural culturalism and development
Long Abstract:
Apparent technology insufficiencies have been a long standing characteristic of African development failure, hardly corrected by the last two decades of economic growth accompanied by resilient inequity. This "shortage" has been especially painful in such a sensible field as health. From Alma Ata, and particularly during XXI Century, WHO has promoted the incorporation of Traditional, Complementary and Integrative Medicine (TCIM) to national health services in order to cope with this technological need. The proposal has been highly adopted in the Subsaharan countries, but the low implementation level and the absence of results evaluation are deceiving expectations, and this trend risks to be ruled out without being really tested, something that would be a huge social irresponsibility.
The panel assumes absence or vagueness of cultural indicators -referred to local knowledge (LK)- as one of the main causes of this impasse, as it makes very difficult to assess the relative efficacies and yields of all actors and therapies connected in African plural health scenario. The panel invites, then, to explore the possibilities of tackling methodological challenges of LK qualitative indicators and multidimensional (holistic) performance (religious, political and sanitary at once) in order to allow utilitarian, contextualised and participative assessing of TCIM strategies South of Sahara.
This panel will be promoted by the researchers' network SACUDA (Salus-Health, Cultures and Development in Africa) and may link participants and interested attendants research initiatives as ALKI (African Local Knowledge Indicators).
Accepted papers:
Session 1 Wednesday 12 June, 2019, -Gefra Fulane (Nova University of Lisbon )
Paper short abstract:
This ethnographic study has found cultural and institutional barriers to the uptake of screening for cervical cancer. "Cancer" as a prefabricated term has a horrifying meaning among women.The use of terms belonging to women's symbolic system is needed to increase preventive attitudes and practices
Paper long abstract:
Caused by Human Papillomavirus, cervical cancer is a big concern, and the 4th major cancer in women worldwide, with about 5527,624 new cases and 265,672 deaths in 2012. Nearly 90% of these deaths occur in low-and-middle-income countries and are mostly associated to late detection of precancerous lesions. The World Health Organization highlights the prevention as the most cost-effective strategy, capable of preventing up to 80% of cervical cancer deaths. Several countries from Sub-Saharan region of Africa have introduced cervical cancer prevention programs, and there are available low-cost techniques like the visual inspection with acetic acid. Nevertheless, a range of barriers limit women from accessing and using these services. In Mozambique, where cervical cancer prevalence ranges from 40 to 96%, only 1% of women aged 30-55 are screened each year. Through an ethnographic study undertaken in the District of Xai-Xai, cultural and institutional barriers came up to be associated with low compliance with cervical cancer screening. Among them, the burden of "cancer" terminology to mean what in women's linguistic system means "cervical wounds" was found as huge barrier, as "cancer" was related to an often silent, unpreventable, untreatable, and deadly disease.For women to take preventive attitude to cervical cancer, screening need to be embedded in women's symbolic system. Bringing local knowledge rather than prefabricated categories is urgent
Victor Kolo (University of Ibadan, Nigeria)
Paper short abstract:
Traditional Bone Setting (TBS), a socio-cultural practice which provides treatment for Musculo-Skeletal Conditions. Studies on TBS attribute adverse treatment outcomes to TBS. This study found that TBS possesses health systems potentials for a viable source of care in resource-constrained settings.
Paper long abstract:
Traditional Bone Setting (TBS) provides more than 70% of treatment for Musculo-Skeletal Conditions (MSCs) in developing countries. Studies have adopted bio-medical approaches in evaluating TBS treatment outcomes. Like other cultural heritage, TBS performs functional roles in today's Africa, which contributes to its persistence. The potentials and prospects of TBS have, however, not been accorded adequate scholarly attention. This paper explores the potentials of TBS in a resource-constrained clime where most of the global MSCs burden are located. Conducted among the Nupe of Nigeria, the study adopted Parsons' theory of the social as theoretical anchor. The study investigated rural health systems, patients' subjective experiences and processes associated with utilizing healthcare for MSCs within an African socio-cultural context. Qualitative methods were adopted in eliciting data from TBS practitioners, patients and primary healthcare workers. Data was content-analyzed and verbatim quotations were used to support themes in the study objectives. Findings revealed that TBS possessed potentials for the production and delivery of quality orthopaedic care towards meeting the SDGs, while contributing to foreign earnings in Africa. Stake factors were identified for the revamping of TBS and its repositioning for occupying the vacuum in orthopaedic healthcare resources in Africa. It was recommended that TBS be explored with a view to consolidating existing feat. Intensified research, capacity building and collaboration with modern orthopaedic practitioners were recommended as strategic approaches.
Patience Gyamenah Okyere Asante (University of Ghana) Deborah Atobrah (University of Ghana)
Paper short abstract:
This paper interrogates how beliefs and conceptualizations about cancer causation influence health care choices among Akan cancer patients in Ghana. The findings of this research elucidate on the relationship between culture and health care choices of cancer patients in Ghana.
Paper long abstract:
In sub-Saharan Africa and in Ghana, in particular, the considerable increase in cancer incidence has become an issue of great concern. However, cancer research has been scanty, with most of these researches being quantitative and biomedical in nature, and focusing on treatments. Using the theory of disease etiology, this study interrogates how cancer patients conceptualize their illness causation and how that influences their health-seeking behaviour. It builds on the assumption that disease causality, as embedded in a people's culture, is crucial to understanding the health care patterns and attitude of the sick towards treatment.
A focused ethnographic approach was used to collect in-depth information for this study. Purposive sampling technique was used to recruit 30 patients from the Komfo Anokye Teaching Hospital in Kumasi. Semi-structured interviews were conducted through face to face interactions with patients to explore their beliefs on illness causation and how these influence their choice of health care.
The study revealed that cancer patients ascribed both physical and spiritual causality to their illness. As such, they combined orthodox treatment with spiritual healing, in essence, "giving to Caesar what is Caesar's and to God what is God's". Regarding the order of therapeutic search, patients reported to herbal and spiritual centers before coming to the hospital, a phenomenon which contributes to the late reporting and diagnosis as well as bad prognosis of cancers in Ghana.
Kalala Ngalamulume (Bryn Mawr College)
Paper short abstract:
Based on archival and oral sources, the paper explores the possibilities of local medical knowledge in Senegal as well as the lost opportunities to integrate it into the colonial and postcolonial health services.
Paper long abstract:
Based on archival and oral sources, the paper explores the possibilities of local medical knowledge in Senegal as well as the lost opportunities to integrate it into the colonial and postcolonial health services. It will examine the ideological, political, and cultural factors as well as technology insufficiencies, which precluded initiatives of integration.