¿Colonialismo biomédico o autonomía de lo local? Sanadores tradicionales contra la tuberculosis

Martos, Ortega; Miguel, Antônio

doi:10.1590/s0104-59702010000400004

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…We propose interactive awareness programmes that acknowledge and appropriately address the variety of local perceptions to enhance early case-finding and reduce hospital delay. Furthermore, patients’ usage of traditional healers, faith healers, and private clinics calls for a collaborative strategy between clinics and these alternative healers, as promoted by the WHO [34] and proven effective according to various studies in sub-Saharan Africa [35–38]. …”

Section: Discussionmentioning

confidence: 99%

Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia

et al. 2016

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BackgroundTuberculosis (TB) remains a major health problem in Zambia, despite considerable efforts to control and prevent it. With this study, we aim to understand how perceptions and cultural, social, economic, and organisational factors influence TB patients’ pre-hospital delay and non-compliance with care provided by the National Tuberculosis Programme (NTP).MethodsA mixed methods study was conducted with 300 TB patients recruited at Kanyama clinic for structured interviews. Thirty were followed-up for multiple in-depth interviews. Six focus group discussions were organised and participant observation was conducted. Ten biomedical care providers, 10 traditional healers, and 10 faith healers were interviewed. Factors associated with non-compliance (disruption of treatment > one week) were assessed by applying logistic regression analyses; qualitative analysis was used to additionally assess factors influencing pre-hospital delay and for triangulation of study findings.ResultsTB treatment non-compliance was low (10 %), no association of outcome with cultural or socio-economic factors was found. Only patients’ time constraints and long distance to the clinic indicated a possible association with a higher risk of non-compliance (OR 0.52; 95 % CI 0.25, 1.10, p = 0.086). Qualitative data showed that most TB patients combined understandings of biomedical and traditional TB knowledge, used herbal, traditional and/or faith healing, suffered from stigmatizing attitudes, experienced poverty and food shortages, and faced several organisational obstacles while being on treatment. This led in some cases to pre-hospital delay or treatment non-compliance.ConclusionsMixed methods analysis demonstrated the importance of in-depth information ascertained by qualitative approaches to understand how cultural, socio-economic and organisational factors are influencing patients’ pre-hospital delay and treatment compliance. To strengthen the Zambian NTP, combating stigma is of utmost priority coupled with programmes addressing poverty. Organisational barriers and co-operation between (private) clinics and traditional/faith healers should be considered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3771-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia

et al. 2016

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Saberes intactos, saberes en contacto. Una revisión feminista del significado del contacto en los debates contemporáneos sobre las relaciones clínicas

Garrido

2023

Asclepio

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En la última década, profesionales de la biomedicina han propuesto varios modelos que parecen plantear un papel renovado y esperanzador para las y los pacientes en las relaciones clínicas. Se trata del modelo de paciente inteligente (“smart patient”) y de otras propuestas procedentes de corrientes humanizadoras de la medicina. En este artículo analizo críticamente el modelo del “smart patient” como un ensamblaje histórico contemporáneo que refleja una tendencia aparentemente positiva en la biomedicina: la revalorización del “contacto” entre profesionales y pacientes, y el fomento de la participación y educación de estas últimas para estar mejor informadas y digitalizadas. Sin embargo, ¿implica esta puesta en valor del contacto una transformación de los saberes expertos? Tomando como guía esta pregunta, en este artículo analizo los límites de los modelos emergentes, y aporto una relectura basada en la perspectiva del contacto. Para ello contrasto dichos modelos, que mantienen los saberes profesionales epistémicamente intactos, con el enfoque de dos trabajos clásicos de la antropología feminista, publicados hace dos décadas, y que abordan críticamente la llamada “Evidence-Based Obstetrics” (Obstetricia Basada en la Evidencia), poniéndolos en diálogo con lecturas fenomenológicas que trascienden una visión del cuerpo basada en el binomio generizado cuerpo / mente. El objetivo es abordar la clínica como una zona de contacto que hay que entender en contextos (g)locales específicos. Este análisis presenta un valor crítico para el presente pues permite argumentar a favor de encuentros ‒entre profesionales, pacientes y organizaciones‒ asentados sobre reequilibrios epistémicos; yendo más allá de modelos de relación que excluyen los conocimientos y experiencias de quienes padecen y con la finalidad de preservar intacto el papel único de los saberes biomédicos.

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¿Colonialismo biomédico o autonomía de lo local? Sanadores tradicionales contra la tuberculosis

Cited by 2 publications

References 17 publications

Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia

Tuberculosis patients’ pre-hospital delay and non-compliance with a longstanding DOT programme: a mixed methods study in urban Zambia

Saberes intactos, saberes en contacto. Una revisión feminista del significado del contacto en los debates contemporáneos sobre las relaciones clínicas

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