Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

Thorsen, Rikke Stamp; Pouliot, Mariève

doi:10.1093/heapol/czv060

Cited by 50 publications

(47 citation statements)

References 51 publications

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“…It also emerged that AYUSH use is relatively low among patients in the middle MPCE quintiles. To some extent, this is similar to the Chinese and Nepalese experience where traditional medicine use is more among higher income households [38,39]. In fact, after adjusting for socioeconomic and demographic variables, we did not observe any significant rural-urban differentials in use of AYUSH services for outpatient care though urban households were more likely to seek medical advice for such care.…”

Section: Discussionsupporting

confidence: 81%

Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

et al. 2017

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AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa and Homeopathy represents the alternative systems of medicine recognized by the Government of India. Understanding the patterns of utilization of AYUSH care has been important for various reasons including an increased focus on its mainstreaming and integration with biomedicine-based health care system. Based on a nationally representative health survey 2014, we present an analysis to understand utilization of AYUSH care across socioeconomic and demographic groups in India. Overall, 6.9% of all patients seeking outpatient care in the reference period of last two weeks have used AYUSH services without any significant differentials across rural and urban India. Importantly, public health facilities play a key role in provisioning of AYUSH care in rural areas with higher utilization in Chhattisgarh, Kerala and West Bengal. Use of AYUSH among middle-income households is lower when compared with poorer and richer households. We also find that low-income households display a greater tendency for AYUSH self-medication. AYUSH care utilization is higher among patients with chronic diseases and also for treating skin-related and musculo-skeletal ailments. Although the overall share of AYUSH prescription drugs in total medical expenditure is only about 6% but the average expenditure for drugs on AYUSH and allopathy did not differ hugely. The discussion compares our estimates and findings with other studies and also highlights major policy issues around mainstreaming of AYUSH care.

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Section: Discussionsupporting

confidence: 81%

Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

et al. 2017

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“…TM offers a cheaper alternative form of health care for the poor and vulnerable; and it is also readily available in rural communities where most low income older adults live (Parmar et al, 2014). As shown in this paper and others, persons with higher incomes are less reliant on TM for their regular health care needs (Pouliot, 2011;Sato, 2012a;Thorsen & Pouliot, 2015), partly because they can afford the cost associated with seeking modern health care as well as pay premiums for health insurance coverage to guarantee access to modern care when needed (Jehu-Appiah et al, 2011;Sato, 2012a;Fenny et al, 2016;Dalinjong et al, 2017). The rich turn to TM only in cases of chronic health where biomedical care fails to provide a cure (Aikins, 2005;Sato, 2012b).…”

Section: Discussionmentioning

confidence: 70%

Modern or traditional health care? Understanding the role of insurance in health-seeking behaviours among older Ghanaians

Amegbor

Kuuire

Bisung

et al. 2019

Prim Health Care Res Dev

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Aim: This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana. Background: There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies. Methods: The study used data from the first wave of the World Health Organisation’s Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors. Findings: Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile. Conclusion: The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.

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“…It was only by the late 1950s that anthropologists began engaging with indigenous forms of healing practices in different cultures under the banner of ethnomedicine-the study of folk illness categories, traditional medical systems and herbal remedies [19,28]. Despite this growing interest in the healthcare services used by different communities, it was however Janzen's [29] seminal study that provided a "holistic picture" of a pluralistic medical system, offering perceptive insights into the simultaneous use of biomedicine and traditional medicine.…”

Section: Biomedical Hegemony Medical Anthropology and Alternative Hementioning

confidence: 99%

“…Despite this growing interest in the healthcare services used by different communities, it was however Janzen's [29] seminal study that provided a "holistic picture" of a pluralistic medical system, offering perceptive insights into the simultaneous use of biomedicine and traditional medicine. Since then anthropologists including Elizabeth Hsu [1], Arthur Kleinman [19] and Cecil Helman [30] have embraced medical pluralism.…”

Section: Biomedical Hegemony Medical Anthropology and Alternative Hementioning

confidence: 99%

“…Contrary to formal healthcare professionals, medicine sellers are further reported to maintain a more cordial and intimate relationship with customers, tailor their ''prescriptions" to the purses of their clients, and 'medicines may also be purchased by proxy' [11,p159]. Medicines are also 'things' in themselves-their 'democratic' and exoteric character confer on them a liberating effect [11,16,[19][20][21][22][23]. In fact, home and self-treatment are significant components of health care, in both the First, but particularly in the Third World [16,21].…”

Section: Introductionmentioning

confidence: 99%

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Self-medication within the context of medical pluralism in Yaounde, Cameroon

Pemunta

Nzefa

Ngo

2019

Preprint

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BackgroundThis paper documents the experiences of patients who use the knowledge and practices of the “African chemist’’, and the determinants of this therapeutic recourse in their ‘quest for therapy’ as ‘quest for relief’ within the context of medical pluralism in Yaounde, Cameroon. MethodThe study adopts a mixed qualitative and quantitative methodological approach comprised of 30 individual in-depth interviews and the administration of 100 questionnaires to participants.ResultThis study neither found that self-medication is wholely nor exclusively preoccupied with therapy for minor physical ailments, but also for diseases and problems with perceived supernatural undertones and for the achievement of personal success and desires. It suggests that social relations, personal experiences and perceptions of trust are central to the choice of the ‘African pharmacy’ as a therapeutic recourse. ConclusionThe popularity of this informal healthcare institution that can be categorized neither under traditional healing nor under modern medicine contradicts the focus on the latter stages of the illness referral system when a patient seeks help from a specialist. This practical case of medical pluralism articulates the need to focus on the local context, on the everyday realities of illness and therapy seeking and to prioritise experiences and social relations that are often obscured in health statistics and development policies.

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Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

Cited by 50 publications

References 51 publications

Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014

Modern or traditional health care? Understanding the role of insurance in health-seeking behaviours among older Ghanaians

Self-medication within the context of medical pluralism in Yaounde, Cameroon

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