Traditional healing and primary care: A socio-cultural study in a rural Tehuledere community, North-Eastern Ethiopia

Abstract

Abstract
Introduction: This study explored the traditional healing practices among Tehuledere communities of Northeastern
Ethiopia with an objective to construct a rural primary health care model.
Methodology: A qualitative ethnographic method was used for this study. Using Kleinman’s Cultural Systems
Model, we conducted participatory observation (5 months over a one year period) supplemented by ten focus
group discussions (n=96) and 20 in-depth interviews with purposefully selected knowledgeable community
members. The focus group and in-depth interviews included questions about the traditional healing as a health care
option, relationship and referral patterns between traditional healers and biomedical care and factor influencing the
decision to seek health care options. In addition, the PI observed 7 traditional healers (2 female and 5 male) and 3
health extension workers while in action and interviewed informally. The notes were expanded, read and re-read to
develop themes and interpretation and narration of findings followed.
Findings: It was found that in Tehuledere pluralistic health-care resources were used either independently or
concurrently with biomedicine. Three categories of traditional healers in the study communities were identified:
Kitel Betash or Herbalists, ‘Awalaj’ or traditional birth attendant and ‘Wogesha’ or local bonesetter. Major reasons
for the use of traditional healers included: perceived etiology of illnesses; the availability and acceptability of
health-care services; the relationship between the health-care practitioners and the patients; socio-economic factors
(cost of health care service); and the influence of social network and/or social relationships. It was also found that
traditional healers have interest to collaborate with bio-medical health-care practitioners.
Conclusion: Members of the study community considers traditional healing by Kitel Betash, Awalaj and Wogesha
as a health care option in a multiple health-care resources. In view of this a successful rural primary health care
strategy would have integrated these into the strategies of rural health care. [Ethiop. J. Health Dev.
2015;29(2):127-136]