title: Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers.
abstract: OBJECTIVE
  In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana.
  
  
  METHODS
  In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.
  
  
  RESULTS
  Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana.
  
  
  CONCLUSIONS
  In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.
authors.affiliation: Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong, China.|Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Razak Mohammed
authors.initials: RM
authors.lastname: Gyasi
authors.affiliation: Department of Geography Education, Faculty of Social Science Education, University of Education, Winneba, Ghana.
authors.forename: Adjoa Afriyie
authors.initials: AA
authors.lastname: Poku
authors.affiliation: Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Simon
authors.initials: S
authors.lastname: Boateng
authors.affiliation: Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong, China.
authors.forename: Padmore Adusei
authors.initials: PA
authors.lastname: Amoah
authors.affiliation: Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Alhassan Abdul
authors.initials: AA
authors.lastname: Mumin
authors.affiliation: Department of Planning and Development, Christian Service University College, Kumasi, Ghana.
authors.forename: Jacob
authors.initials: J
authors.lastname: Obodai
authors.affiliation: Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Williams
authors.initials: W
authors.lastname: Agyemang-Duah
mesh_terms: D001290:Attitude; D001291:Attitude of Health Personnel; D003142:Communication; D000529:Complementary Therapies / Q000193:education; D003299:Cooperative Behavior; D003695:Delivery of Health Care; D005869:Ghana; D006282:Health Personnel; D006291:Health Policy; D006801:Humans; D055048:Integrative Medicine / Q000193:education; D016488:Medicine, African Traditional