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. 2020 Jul;103(1):501-507.
doi: 10.4269/ajtmh.19-0897. Epub 2020 May 21.

Factors Motivating Traditional Healer versus Biomedical Facility Use for Treatment of Pediatric Febrile Illness: Results from a Qualitative Study in Southwestern Uganda

Anneka Hooft  1 , Doreen Nabukalu  2 , Juliet Mwanga-Amumpaire  3 , Michael A Gardiner  1 , Radhika Sundararajan  4   5
Affiliations

Factors Motivating Traditional Healer versus Biomedical Facility Use for Treatment of Pediatric Febrile Illness: Results from a Qualitative Study in Southwestern Uganda

Anneka Hooft et al. Am J Trop Med Hyg. 2020 Jul.

Abstract

Febrile illnesses, such as malaria and pneumonia, are among the most common causes of mortality in children younger than 5 years in Uganda outside of the neonatal period. Their impact could be mitigated through earlier diagnosis and treatment at biomedical facilities; however, it is estimated that a large percentage of Ugandans (70-80%) seek traditional healers for their first line of medical care. This study sought to characterize individual and structural influences on health care-seeking behaviors for febrile children. Minimally structured, qualitative interviews were conducted for 34 caregivers of children presenting to biomedical and traditional healer sites, respectively. We identified six themes that shape the pathway of care for febrile children: 1) peer recommendations, 2) trust in biomedicine, 3) trust in traditional medicine, 4) mistrust in providers and therapies, 5) economic resources and access to health care, and 6) perceptions of child health. Biomedical providers are preferred by those who value laboratory testing and formal medical training, whereas traditional healer preference is heavily influenced by convenience, peer recommendations, and firm beliefs in traditional causes of illness. However, most caregivers concurrently use both biomedical and traditional therapies for their child during the same illness cycle. The biomedical system is often considered as a backup when traditional healing "fails." Initiatives seeking to encourage earlier presentation to biomedical facilities must consider the individual and structural forces that motivate seeking traditional healers. Educational programs and cooperation with traditional healers may increase biomedical referrals and decrease time to appropriate care and treatment for vulnerable/susceptible children.

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Figures

Figure 1.
Figure 1.
Factors influencing health care–seeking behavior at traditional healer and biomedical sites.
See this image and copyright information in PMC

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