BackgroundA substantial proportion of healthcare professionals have inadequate understanding of traditional and complementary medicine and often consider their use inappropriate.MethodsWe conducted a qualitative study to understand the perceptions and attitudes of medical students, medical school faculty and traditional and complementary medicine practitioners. In-depth interviews and focus group discussions were used to collect data. Thematic approach was used in data analysis to identify emerging themes and sub themes. Data analysis was supported with use of Atlas.ti v6.1.1.ResultsThe majority of participants commended the inclusion of traditional and complementary medicine principles into medical school curricula. The main reasons advanced were that: patients are already using these medicines and doctors need to understand them; doctors would be more accommodating to use and not rebuke patients, thereby minimizing delays in care due to pursuit of alternative therapies; promote patient safety; foster therapeutic alliance and adherence to therapy; uphold patients' right to self-determination; lead to discovery of new drugs from traditional medicines; and set ground for regulation of practices and quality control. However, participants anticipated operational and ethical challenges that include inadequate number of faculty to teach the subject, congested curricula, increased costs in research and development to produce evidence-base data, obstruction by pharmaceutical companies, inaccessibility to and depletion of medicinal plants, and potential conflicts due to diversity in culture and values. A substantial minority of participants thought traditional medicine need not be taught in medical schools because there is lack of scientific evidence on efficacy, safety, and side effects profiles. These shortfalls could make the determination of benefits (beneficence) and harm (maleficence) difficult, as well as compromise the ability of physicians to adequately disclose benefits and harms to patients and family, thereby undermining the process of informed consent and patient autonomy.ConclusionsTraining medical students in principles of traditional and complementary medicine is considered reasonable, feasible, and acceptable; and could lead to improvement in health outcomes. There are anticipated challenges to implementing a hybrid medical school curricula, but these are surmountable and need not delay introducing traditional and complementary medicine principles into medical school curricula in Uganda.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1419-4) contains supplementary material, which is available to authorized users.
Social protection continues to gain increased attention in Uganda's national development discourse and beyond, because of its ability to mitigate risk and vulnerability perpetuated by poverty. Despite this impetus, less research has been undertaken to expanding social protection to children living on the streets. Yet, Uganda's increase in urbanization has been associated with the high influx of children living on the streets in some major towns, especially Kampala. Therefore, this study sought to examine social protection mechanisms for children living on the streets of Uganda, a case study of Kampala. This qualitative study was conducted using content analysis and in-depth interviews with both key informants and children living on the streets. The study found that in-kind social protection services existed but hardly accessed. In some cases, these services were accessed through third parties. The government outlawed provision of services to the children while on the streets as a deterrent, but counterproductive measure, to minimize their influx into Kampala city. However, there was in-kind social protection support for children withdrawn from the streets, under rehabilitation, characterized by severe government underfunding, donor driven, and charity, not human rights based. The study contends that a change in national investment priorities, to include social protection of children living on the streets, can transform the lives of children living on the streets and their communities.
For over two decades now, Sub-Saharan Africa has been superimposed in a coercive and contradictory neo-liberal development economism agenda. According to this paradigm, markets and not states are the fundamental determinants of distributive justice and human flourishing through the promotion of economic growth that is believed to trickle down to the poor in due time. Despite the global intellectual criticism of this neo-liberal development economics orthodox of measuring development and wellbeing in terms of market induced economic growth, autocratic states in Sub-Saharan Africa that have accumulated un-dimensional growth continue to be applauded as role models on poverty reduction, wellbeing and social justice by donors and global development institutions such as the World Bank and international monetary fund (IMF). This is basically because they have wholly embraced the implementation of the anti-pro-poor neo-liberal structural adjustment tool kit. This study uses a critical hermeneutics methodology to expose the distortions embedded in neo-liberal gross domestic product (GDP) growth cartographies and how these disguise the social injustices against the poor in SubSaharan Africa with particular reference to Uganda. The study contends that in measuring development and wellbeing, human rights and social justice must take precedence over economic efficiency and GDP growth for that matter.
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