1. Jackson Kaguamba, Dr. MPH, Sphiwe Madiba, MPH
Attitudes of biomedicine and alternative medicine practitioners towards collaboration in patient care. Tutume Sub-district- Botswana
Jackson Kaguamba, Dr. MPH, Sphiwe Madiba, MPH
School of Public Health, University of Limpopo, Medunsa Campus. South Africa
Results
Background
Results
Background
The government of Botswana through its National Health Policy encourages collaboration between biomedicine and alternative medicine practitioners. The main objective was to foster contact between the two sides to begin discussions on issues of collaboration and to:
Promote and foster mutual respect between the two sides
Facilitate and maintain dialogue in the form of seminars and workshops
Encourage and support research into traditional medicine.
Eleven years after the formulation of policy there has not been documentation on how collaboration has unfolded in the country, and this study aimed to fill this gap.
Objectives
To examine the attitudes of the biomedical and alternative medicine practitioners towards collaboration.
To determine collaboration activities that has been going on in the sub district
To determine the approach that is recommended by the two sides to promote and strengthen collaboration
Demographic profile of participants
Gender
AM practitioners- more males 25 (64.1%) as compared to 14 (35.9%) females
BM practitioners - more females 36 (60%)
as compared to24 (40%) males
Age
AM practitioners – majority 32 (82%) were above 40yrs
BM practitioners- majority 40 (80%) were
below 40yrs
BM’s interaction with AM practitioners (72.9 %) have never interacted, 16 (27.1%) have had a form of interaction
BM’s opinions of AM practitioners –
4 (6.7%) they were colleagues, 31 (51%) they were useful in some selected cases, 10 (16.7%) they were quacks, 18 (30 %) were not sure.
BM’s opinions on collaboration –
44 (80%) said yes and 11(20%) said no to collaboration.
AM’s attitudes of Biomedicine
23 (57.5%) said it was useful to an extent, 12 (30.8%) said it was useful and 3 (7. 7%) said it was not useful.
AM’s opinions of BM practitioners (92.1%) said colleagues and 3 (7.9%) said they were not
AM’s opinions on collaboration
37 (95%) said yes and 2 (5%) said no to collaboration
Alternative practitioners
Active collaboration and
consultation with AM (n=46) No
57%
Yes
44%
Exchange skills and information
(n=48)
29%
53%
Integration of the two systems
under the same roof (n=47)
81%
19%
Students learning BM skills
Should also learn AM (n=47)
66%
34%
Collaboration be minimized to
patient referral (n=44)
36%
63%
Sharing knowledge with
BM practitioners (n=49)
Yes
85% No
15%
other AM practitioners
77%
23%
AM practitioners learning some BM skills
74.%
26%
Willingness to
participate in workshops
92% 8%
Referring patients to each other
95% 5%
Biomedical participants-
Doctors – 15, Nurses – 30, Pharmacist – 7, Social workers – 2, Medical tech – 6
AM practitioner’s educational level
Only 45 % of AM practitioners were members of Botswana Traditional healers association
Materials and Method
Conclusion
Study site
Tutume sub district in Botswana
Two district hospitals, 28 clinics and health posts
Approximately 150 health professionals
Population size (2001 census)
Unknown number of alternative practitioners
Biomedical practitioners were willing to share knowledge with alternative practitioners for the benefit of patients; however this would be on their terms as the majority was not familiar with and not willing to learn any alternative medicine skills
Biomedical practitioners have negative attitude towards alternative medicine practitioners and collaboration
It was also evident that there has been very little collaboration between the two practitioners- however if there should be collaboration it is seen as a way of encouraging patient referral from AM and a means of teaching them safer practices
Patient referral was regarded as the preferred approach to collaboration – but it was also done for the benefit of the patients and seen as a way of referring from AM to BM
On the other hand all alternative medicine practitioners were in favour of collaboration, and have a positive attitude towards biomedicine practitioners whom they view as colleagues, and are willing to share knowledge with them.
Tutume
BM’s attitude towards AM practice
Only 11 (18.6%) BM practitioners were aware Ministry of Health’s Policy on Traditional Healers
Majority 52 (89.7%) would not refer a patient to AM practitioners, only 6 (10.3%) said they would
Majority 39 (66.1%) had no desire to learn any form of AM, 20 (33.9%) said they did, (n= 59)
Descriptive survey - structured questionnaires
Biomedical Practitioners (n=60)
Alternative medicine practitioners (n=40)
Data on - demographics, types of AM practices, attitudes on collaboration, approaches to and level of collaboration
Spiritual Healer
Collaborative activities between BM and AM Practitioners.
Collaboration was limited to workshops and seminars attendance by 9 (56%) n=16
Patient referral to AM was reported by 4(25%) n=16
Only 17 (30%) of BM practitioners attended collaborative meetings twice a year
Recommendations
Literature Cited
Bishow M (1990) Attitudes Of Modern And Traditional Medical Practitioners Toward
Cooperation. Ethiop Med J April; 28(2)
Green E- (n.d) Can Collaborative Programmes between Biomedicine and Indigenous
Health Practitioners Succeed? -
A full scale study with a much bigger study population and using both quantitative and qualitative methods should be conducted to further explore the area on collaboration between the two sides,
Typical Traditional Healer