Department of Sociology and Social Policy, Faculty of Social Sciences, Lingnan University, Hong Kong, China.
Department of Geography and Rural Development, Faculty of Social Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
J Integr Med. 2017 Jan;15(1):44-55. doi: 10.1016/S2095-4964(17)60312-1.
In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana.
In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.
Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana.
In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.
尽管世界卫生组织在过去几十年中提出了建议，但加纳的医疗体系仍然是多元化的，而不是真正的综合医疗体系。将补充医学纳入国家医疗保健提供系统的整合政策需要考虑到医疗保健提供者的个人参与和文化可接受性。然而，加纳的研究忽略了疾病患者对跨文化医疗保健政策框架的立场。本文探讨了加纳的医疗保健使用者和提供者对实施跨文化医疗保健政策的经验和态度。
在加纳阿散蒂地区的Sekyere South 区和库马西大都市区，对 16 名卫生服务使用者、7 名传统治疗师和 6 名卫生专业人员进行了深入访谈，并辅以非正式对话。数据采用主题分析方法进行分析，并根据后验归纳还原方法进行呈现。
研究结果表明，加纳广泛存在对综合医疗保健的积极态度和支持。然而，治疗师和卫生专业人员之间很少进行交叉转诊等形式的跨提供者沟通，这种沟通也没有得到正式认可。传统治疗师和卫生保健专业人员对跨文化医疗保健政策持怀疑态度，主要是因为缺乏对提供者教育的政治承诺。医疗从业者接受综合医疗实践培训的机会有限。我们还发现，由于“治疗方法和技术的多样性”，从业者之间存在严重的不信任。机构支持薄弱、缺乏符合实践标准的培训、注册和监管措施不力以及对综合医疗政策的负面看法，都抑制了该政策在加纳的实施。
为了在加纳推进任何有用的跨文化医疗保健政策，政府需要全面承诺提供信息培训和提供者教育、执行监管工具以及改善社区参与。将传统医学疗法纳入临床实践的循证整合将为服务不足和资源匮乏的人群，特别是在农村地区，提供更安全、更快和更有效的医疗保健。
