Macfarlane Joan Elizabeth, Alpers Michael P
Curtin University of Technology, Centre for International Health, Perth, Australia.
Ethn Health. 2009 Apr;14(2):147-68. doi: 10.1080/13557850802546588.
In Papua New Guinea (PNG) there continues to be considerable interest in developing a health system that incorporates both traditional and western medicine. A policy on traditional medicine has recently been endorsed. Simultaneously, there is limited information about the traditional beliefs and practices that influence treatment-seeking behaviour.
A case study among the Nasioi people of Bougainville was conducted to gather information that could help to inform the implementation of the National Policy on Traditional Medicine for PNG.
The main objective of the case study was to describe how health knowledge and belief systems influence treatment-seeking behaviour, specifically in relation to the use of traditional and western health care systems. The study also sought to develop an explanatory model for decision-making responses to febrile illnesses and skin conditions.
By using a non-experimental, cross-sectional study design and focused ethnographic approach, a sample of 200 Nasioi community members were interviewed by Nasioi-speaking research assistants.
The study found that people in the sample group subscribe to both traditional and western medical paradigms. Western medical concepts have been assimilated but have not displaced traditional understanding of illness. There was congruence between beliefs about causes of illness, treatment-seeking responses to illness and stated or hypothetical preferences for traditional or western medicine. Data obtained in each of these domains reflect concepts of illness derived from both medical paradigms and demonstrate participants' confidence in the efficacy of both traditional and western medicine.
It is proposed that a health system that incorporates traditional medicine may be better aligned with people's concepts of illness than the current system. Because it is more consistent with Nasioi concepts of illness, an incorporated health system may lead to more appropriate health service utilisation and, ultimately, to improvements in population health status.
在巴布亚新几内亚（PNG），人们对建立一个融合传统医学和西医的卫生系统仍有着浓厚兴趣。一项关于传统医学的政策最近已获批准。与此同时，关于影响就医行为的传统信仰和习俗的信息却很有限。
在布干维尔的纳西奥伊人群体中开展了一项案例研究，以收集有助于为巴布亚新几内亚传统医学国家政策的实施提供参考的信息。
该案例研究的主要目标是描述健康知识和信仰体系如何影响就医行为，特别是在使用传统和西医卫生保健系统方面。该研究还试图为对发热疾病和皮肤疾病的决策反应建立一个解释模型。
采用非实验性横断面研究设计和重点人种志方法，由会说纳西奥伊语的研究助理对200名纳西奥伊社区成员进行了访谈。
研究发现，样本组中的人们同时认同传统医学和西医范式。西医概念已被吸收，但并未取代对疾病的传统理解。在疾病成因的信念、对疾病的就医反应以及对传统医学或西医的既定或假设偏好之间存在一致性。在这些领域中获得的数据反映了源自两种医学范式的疾病概念，并表明参与者对传统医学和西医疗效的信心。
有人提出，一个融合传统医学的卫生系统可能比现行系统更符合人们的疾病观念。由于它更符合纳西奥伊人的疾病观念，一个融合的卫生系统可能会导致更合理地利用卫生服务，并最终改善人群健康状况。
