Department of Population Medicine, University of Guelph, Guelph, Canada.
School of Earth and Environment, University of Leeds, Leeds, UK.
Glob Public Health. 2022 Aug;17(8):1757-1772. doi: 10.1080/17441692.2021.1937273. Epub 2021 Jun 7.
The Batwa (Twa), an Indigenous People of southwest Uganda, were evicted from their ancestral forest lands in 1991 due to establishment of the Bwindi Impenetrable Forest. This land dispossession forced Batwa to transition from a semi-nomadic, hunting-gathering livelihood to an agricultural livelihood; eliminated access to Indigenous food, medicines, and shelter; and shifted their healthcare options. Therefore, this exploratory study investigated why Batwa choose Indigenous or biomedical treatment, or no treatment, when experiencing acute gastrointestinal illness. Ten gender-stratified focus groups were conducted in five Batwa settlements in Kanungu District, Uganda ( = 63 participants), alongside eleven semi-structured interviews (2014). Qualitative data were analysed thematically, using a constant comparative method. Batwa emphasised that health-seeking behaviour for acute gastrointestinal illness was diverse: some Batwa used only Indigenous or biomedical healthcare, while others preferred a combination, or no healthcare. Physical and economic access to care, and also perceived efficacy and quality of care, influenced their healthcare decisions. This study provides insight into the Kanungu District Batwa's perceptions of biomedical and Indigenous healthcare, and barriers they experience to accessing either. This study is intended to inform public health interventions to reduce their burden of acute gastrointestinal illness and ensure adequate healthcare, biomedical or Indigenous, for Batwa.
巴图阿人（也称特瓦人）是乌干达西南部的一个原住民群体，1991 年，由于布温迪难以穿越国家森林的建立，他们被驱逐出祖传的森林土地。这次土地剥夺迫使巴图阿人从半游牧、狩猎采集的生计方式转变为农业生计方式；他们失去了获得本土食物、药物和住所的机会；并改变了他们的医疗选择。因此，这项探索性研究调查了当巴图阿人经历急性胃肠道疾病时，他们为什么选择原住民医疗或生物医学治疗，或者不治疗。研究在乌干达卡农古区的五个巴图阿人定居点进行了十组性别分层焦点小组（ = 63 名参与者），并进行了十一次半结构访谈（2014 年）。使用恒定比较法对定性数据进行主题分析。巴图阿人强调，急性胃肠道疾病的寻医行为是多种多样的：一些巴图阿人只使用原住民医疗或生物医学医疗，而另一些人则更喜欢两者结合，或者不治疗。获得医疗的身体和经济条件，以及对医疗的疗效和质量的认知，影响了他们的医疗决策。本研究深入了解了卡农古区巴图阿人对生物医学和原住民医疗的看法，以及他们在获得这两种医疗服务方面所面临的障碍。本研究旨在为减少急性胃肠道疾病给巴图阿人带来的负担，并确保他们获得足够的医疗服务，无论是生物医学还是原住民医疗，提供信息。
