Ng'ang'a Naomi Wambui, Momanyi Reuben Onkoba, Chemirmir Caleb, Biwott Hazael, Ayodo George, Orero Monica, Ochanda Damaris, Ngere Sarah, Ogola Winnie, Murundu Titus, Munene Geoffrey, Misiani Zachary, Ayabei Michael, Kiaka Richard Dimba
Kenya Red Cross Society, Nairobi, Kenya.
Jaramogi Oginga Odinga University of Science and Technology (JOOUST), Bondo, Kenya.
PLOS Glob Public Health. 2025 Mar 25;5(3):e0003228. doi: 10.1371/journal.pgph.0003228. eCollection 2025.
Cultural and religious practices and beliefs have historically played a significant role in the management of disease outbreaks globally. This study explored how such beliefs and healing practices shape the vulnerability of communities to highly infectious diseases in three border counties in western Kenya-Homa Bay, Bungoma, and West Pokot. Using an empirical qualitative research design, we conducted 45 key informant interviews with 13 traditional healers, 16 religious healers, and their 16 patients. We also held 6 focus group discussions with community members knowledgeable about cultural customs and practices, and 1 participatory inquiry workshop with health professionals and administrators. The findings indicated that traditional and religious beliefs and healing practices influence community vulnerability to highly infectious diseases in two main ways. Firstly, we identified a dualistic illness etiology that includes both biomedical and socio-cultural interpretations. Traditional and religious healers often served as the first point of care for unexplained illnesses or those unresponsive to conventional medicine, which could delay appropriate treatment and compromise safe handling in case of highly infectious diseases. Second, we found that traditional and spiritual healing practices pose certain risks. Practices such laying of hands, use of herbs and rituals involving slaughtering of animals enhanced contacts. The use of protective gear among healers was inconsistent and often absent due to cost or fears that it could undermine the patient's faith in the healer's powers. These practices can potentially predispose individuals to highly infectious diseases, enhancing transmission and symptom severity. To mitigate the vulnerability of border communities to highly infectious diseases, we recommend comprehensive strategies that address the intersection of vulnerability factors, including healing beliefs and practices. This may involve policy initiatives to integrate traditional medicine practices with the mainstream health system, thereby enhancing disease prevention and control efforts.
从历史上看，文化和宗教习俗及信仰在全球疾病爆发的管理中发挥了重要作用。本研究探讨了这些信仰和治疗方式如何影响肯尼亚西部三个边境县——霍马湾、邦戈马和西波科特的社区对高传染性疾病的易感性。我们采用实证定性研究设计，对13名传统治疗师、16名宗教治疗师及其16名患者进行了45次关键 informant 访谈。我们还与熟悉文化习俗和做法的社区成员进行了6次焦点小组讨论，并与卫生专业人员和管理人员举办了1次参与式调查研讨会。研究结果表明，传统和宗教信仰及治疗方式主要通过两种方式影响社区对高传染性疾病的易感性。首先，我们确定了一种二元疾病病因，包括生物医学和社会文化两种解释。传统和宗教治疗师往往是无法解释的疾病或对传统医学无反应的疾病的第一护理点，这可能会延迟适当的治疗，并在发生高传染性疾病时危及安全处理。其次，我们发现传统和精神治疗方式存在一定风险。诸如按手礼、使用草药以及涉及宰杀动物的仪式等做法增加了接触。由于成本或担心这会削弱患者对治疗师能力的信任，治疗师使用防护装备的情况不一致且往往没有。这些做法可能会使个人更容易感染高传染性疾病，增加传播和症状严重程度。为了减轻边境社区对高传染性疾病的易感性，我们建议采取全面战略，解决包括治疗信仰和做法在内的脆弱性因素的交叉问题。这可能涉及政策举措，将传统医学做法与主流卫生系统相结合，从而加强疾病预防和控制工作。
