Introduction to the special issue ‘medical pluralism and beyond’

Penkala–Gawęcka, Danuta; Rajtar, Małgorzata

doi:10.1080/13648470.2016.1180584

Cited by 22 publications

(14 citation statements)

References 14 publications

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“…Like many others in the sub-region, patients in Ghana have the opportunity to shop for healing from various systems/care providers: the allopathic health services delivery system, indigenous/traditional care delivery systems, as well as faith-based providers. Referred to as medical pluralism [40] or more recently, medical diversity [41], the use of multiple medical systems to address illness and wellness, has been praised and criticised at the same time [42]. The medical sociology, and anthropological literature address the subject in-depth.…”

Section: Patient-level Challenges Including Multiple Understandings Omentioning

confidence: 99%

Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

Laar

Adler

Kotoh

et al. 2019

Preprint

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Background Hypertension, itself a cardiovascular condition, is a significant risk factor for other cardiovascular diseases. Hypertension is recognised as a major public health challenge in Ghana. Beginning in 2014, a collaborative team launched the community-based hypertension improvement program (ComHIP) in one health district in Ghana. The ComHIP project, a public-private partnership, tests a community-based model that engages the private sector and utilizes information and communication technology (ICT) to control hypertension. This paper, however, focuses on the various challenges associated with managing hypertension in Ghana, as reported by ComHIP stakeholders. Methods A total of 55 informants – comprising patients, health care professionals, licensed chemical sellers (LCS), national and sub-national policy makers – were purposively selected for interview and focus group discussions (FGDs). Interviews were audio-recorded and transcribed verbatim. Where applicable, transcriptions were translated directly from local language to English. The data were then analysed using two-step thematic analysis. The protocol was approved by the two ethics review committees based in Ghana and the third, based in the United Kingdom. All participants were interviewed after informed consent. Results Our data have implications for the on-going implementation of ComHIP, especially the importance of policy maker buy-in, the benefits, as well as drawbacks of the program to different stakeholders. While our data show that the ComHIP initiative is acceptable to patients and healthcare providers – increasing providers’ knowledge on hypertension and patients’ awareness of same, there were implementation challenges identified by both patients and providers. Policy level challenges relate to task-sharing bottlenecks, which precluded nurses from prescribing or dispensing antihypertensives, and LCS from stocking same. Medication adherence, and the phenomenon of medical pluralism in Ghana, were identified challenges. The perspectives from the national level stakeholders enable elucidation of whole of health system challenges to ComHIP and therefore similarly designed future programmes. Conclusions This paper sheds important light on the patient/individual, and system level challenges to hypertension and related non-communicable disease prevention and treatment in Ghana. The data show that although the ComHIP initiative is acceptable to patients and healthcare providers, policy level task-sharing bottlenecks preclude optimal implementation of ComHIP.

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Section: Patient-level Challenges Including Multiple Understandings Omentioning

confidence: 99%

Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

Laar

Adler

Kotoh

et al. 2019

Preprint

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“…Medical pluralism refers to different therapeutic practices occurring side by side within a geographical space (Horbst et al, 2017; Penkala-Gawęcka & Rajtar, 2016). Theorists have argued that the idea of medical pluralism fails to incorporate the realities of globalization and increasing mobility of populations across local, national, and international landscapes (Penkala-Gawęcka & Rajtar, 2016). Problems with a static view of medical pluralism become evident when examining the terminology used to define therapeutic approaches toward health care.…”

Section: Introductionmentioning

confidence: 99%

Traditional Medicine and Help-Seeking Behaviors for Health Problems Among Somali Bantu Refugees Resettled in the United States

et al. 2020

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Somali refugees have resettled in the United States in large numbers. The focus of this study was specifically on the Somali Bantu refugees, an ethnic minority group from Somalia. The goal of this study was to understand the following: (a) jinn (invisible beings or forces in Islamic theology) and related health problems resulting from jinn possession affecting Somali Bantu refugees, (b) types of traditional healing practices integrated into help-seeking behavior, and (c) pathways of care utilized to address health problems. In total, 20 participant interviews were conducted with Somali Bantu refugees resettled in the United States. Overall, participants described types of jinn and associated health problems. In addition, participants identified different pathways of care, including formal and informal health care. Participants accessed these pathways both concurrently and sequentially. Somali Bantu utilize complex and varied health care services based on their understanding of the causes of health problems and experiences with care providers.

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“…This type of analysis prompts Penkala-Gawęcka and Rajtar (2016: 129) to suggest that the term medical pluralism should be replaced by more fluid alternatives such as ‘medioscapes’, to enable reflection on the ‘distinct results of ongoing globalised entanglements in the international medical arena’ or ‘medical diversity’, ‘super-diversity’ or ‘hyper-diversity’, which in turn allow for the acknowledgment of complex and mutual borrowing between medical traditions.…”

Section: Subaltern Therapeutics: a Post-colonial Interpretation Of Mementioning

confidence: 99%

Medical Pluralism, Mainstream Marginality or Subaltern Therapeutics? Globalisation and the Integration of ‘Asian’ Medicines and Biomedicine in the UK

Cant

2020

Society and Culture in South Asia

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Medical Pluralism refers to the coexistence of differing medical traditions and practices grounded in divergent epistemological positions and based on distinctive worldviews. From the 1970s, a globalised health market, underpinned by new consumer and practitioner interest, spawned the importation of ‘non-Western’ therapeutics to the UK. Since then, these various modalities have coexisted alongside, and sometimes within, biomedical clinics. Sociologists have charted the emergence of this ‘new’ medical pluralism in the UK, to establish how complementary and alternative medicines have fared in both the private and public health sectors and to consider explanations for the attraction of these modalities. The current positioning of complementary and alternative medicines can be described as one of ‘mainstream marginality’ ( Cant 2009 , The New Sociology of the Health Service, London: Routledge): popular with users, but garnering little statutory support. Much sociological analysis has explained this marginal positioning of non-orthodox medicine by recourse to theories of professionalisation and has shown how biomedicine has been able, with the support of the state, to subordinate, co-opt and limit its competitors. Whilst insightful, this work has largely neglected to situate medical pluralism in its historical, global and colonial contexts. By drawing on post-colonial thinking, the paper suggests how we might differently theorise and research the appropriation, alteration and reimagining of ‘Asian’ therapeutic knowledges in the UK.

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Introduction to the special issue ‘medical pluralism and beyond’

Cited by 22 publications

References 14 publications

Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

Health system challenges to hypertension and related non-communicable diseases prevention and treatment: perspectives from Ghanaian stakeholders

Traditional Medicine and Help-Seeking Behaviors for Health Problems Among Somali Bantu Refugees Resettled in the United States

Medical Pluralism, Mainstream Marginality or Subaltern Therapeutics? Globalisation and the Integration of ‘Asian’ Medicines and Biomedicine in the UK

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