title: The traditional healer in obstetric care: A persistent wasted opportunity in maternal health.
abstract: Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs.
authors.affiliation: Global Public Health and South East Asia Community Observatory (SEACO), School of Medicine and Health Sciences, Monash University, Malaysia; Navrongo Health Research Centre, Navrongo, Ghana. Electronic address: raabo2@student.monash.edu.
authors.forename: Raymond Akawire
authors.initials: RA
authors.lastname: Aborigo
authors.affiliation: Global Public Health and South East Asia Community Observatory (SEACO), School of Medicine and Health Sciences, Monash University, Malaysia.
authors.forename: Pascale
authors.initials: P
authors.lastname: Allotey
authors.affiliation: Global Public Health and South East Asia Community Observatory (SEACO), School of Medicine and Health Sciences, Monash University, Malaysia.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Reidpath
mesh_terms: D000328:Adult; D003906:Developing Countries; D005260:Female; D017144:Focus Groups; D005869:Ghana; D066296:Grounded Theory; D006801:Humans; D008297:Male; D008427:Maternal Health Services / Q000379:methods; D016488:Medicine, African Traditional; D008875:Middle Aged; D008880:Midwifery / Q000706:statistics & numerical data*; D009774:Obstetrics; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D012424:Rural Population; D000078329:Workforce
keywords: Ghana; Maternal morbidity; Obstetric care; Traditional birth attendants; Traditional healers; Traditional practitioners