Yempabe Tolgou, Edusei Anthony, Donkor Peter, Buunaaim Alexis, Mock Charles
Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana.
Kwame Nkrumah University of Science and Technology, School of Public Health, Kumasi, Ghana.
Afr J Emerg Med. 2021 Mar;11(1):105-110. doi: 10.1016/j.afjem.2020.09.002. Epub 2020 Sep 30.
Traditional bonesetters (TBS) are still highly patronized by people with fractures in Africa. We sought to investigate factors affecting the utilization of TBS services in the Northern Region of Ghana.
A mixed-methods study that combined both qualitative and quantitative approaches was conducted among 64 TBS clients in the Northern Region of Ghana. Participants were purposively selected and should have utilized the services of TBSs at the time of the study. In addition, three focus group discussions (FGDs) were conducted to complement the quantitative results. Quantitative analysis was performed by calculating means and proportions. For the qualitative data, content analysis was done manually based on emerging themes in line with the study objectives.
Sixty-four (64) clients were recruited. Twenty-four (37.5%) were female. The modal age group was 19-39 years. The educational status of the clients was dominated by primary/junior secondary education (39.1%), but included the full spectrum from no formal education / illiterate (26.6%) to tertiary (12.5%). Cheaper fees (26.3%), cultural beliefs (17.9%), and quick service (15.9%) were the main reason of patronizing TBSs. Twenty-two (34.3%) would have preferred orthodox care and the reasons cited included availability of X-rays (27.3%) and pain management (25.3%). These themes were reiterated by FGDs with an additional 30 clients. Additional themes identified by the FGDs included a belief that TBSs address both physical and spiritual aspects of the injury and the major role that families (not the injured person alone) make in deciding on type of treatment. Clients were supportive of orthodox providers linking with TBSs for activities such as training to improve pain control.
TBSs have patronage from the full spectrum of society. The decision to opt for TBS treatment was influenced by cheaper fees, cultural belief, and quick service. TBS clients wanted greater linkages between TBSs and orthodox providers.
在非洲，骨折患者仍高度青睐传统接骨师。我们试图调查影响加纳北部地区传统接骨师服务利用情况的因素。
在加纳北部地区对64名传统接骨师的客户进行了一项结合定性和定量方法的混合方法研究。参与者是经过有目的地选择的，且在研究时应已使用过传统接骨师的服务。此外，还进行了三次焦点小组讨论以补充定量研究结果。定量分析通过计算均值和比例进行。对于定性数据，根据符合研究目标的新出现主题进行人工内容分析。
招募了64名客户。其中24名（37.5%）为女性。年龄中位数组为19 - 39岁。客户的教育程度以小学/初中教育为主（39.1%），但涵盖了从无正规教育/文盲（26.6%）到高等教育（12.5%）的全范围。费用低廉（26.3%）、文化信仰（17.9%）和服务快捷（15.9%）是光顾传统接骨师的主要原因。22名（34.3%）客户更倾向于正规医疗护理，提及的原因包括可进行X光检查（27.3%）和疼痛管理（25.3%）。另外30名客户参加的焦点小组讨论重申了这些主题。焦点小组讨论确定的其他主题包括认为传统接骨师能解决损伤的身体和精神两方面问题，以及家庭（而非仅受伤者本人）在决定治疗类型方面起主要作用。客户支持正规医疗服务提供者与传统接骨师建立联系，开展如培训以改善疼痛控制等活动。
传统接骨师受到社会各阶层的光顾。选择传统接骨师治疗的决定受费用低廉、文化信仰和服务快捷的影响。传统接骨师的客户希望传统接骨师与正规医疗服务提供者之间有更多联系。
