Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

Abstract

Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.

Role of traditional beliefs in the knowledge and perceptions of mental health and illness amongst rural-dwelling women in western Nigeria

“…As revealed in a study, orthodox medicine has fallen below expectations of patients and their caregivers, and both groups of practitioners also expressed reservations regarding collaboration. 41 In general, observations from this study align with those of recent scoping reviews of the knowledge and attitude towards mental illness in Nigeria. 42,43 The reviews covered institutional and community levels in different parts of the country.…”

“…As revealed in a study, orthodox medicine has fallen below expectations of patients and their caregivers, and both groups of practitioners also expressed reservations regarding collaboration. 41 …”

Traditional and faith-based healthcare in the management of psychotic disorders in Africa: in search for synergy

“…In line with previous research on general mental health [31,32], all stakeholders report serious concerns regarding shared management of psychotic patients [20 ▪ ,41 ▪ ]. In Ghana, TFH, patients and caregivers mentioned fear of disrespect and undue criticism by biomedical practitioners as important obstacles, while primary health providers mentioned the potential harm of traditional treatments [20 ▪ ]. As opposed to reports on general mental health [32], a study at a holy water site in Ethiopia, where mostly psychotic patients were treated, reported that incompatibility of beliefs was an important reason for resistance among some of the holy water attendants to refer patients to the psychiatric clinic [41 ▪ ].…”

“…In line with previous research on general mental health [31,32], all stakeholders report serious concerns regarding shared management of psychotic patients [20 ▪ ,41 ▪ ]. In Ghana, TFH, patients and caregivers mentioned fear of disrespect and undue criticism by biomedical practitioners as important obstacles, while primary health providers mentioned the potential harm of traditional treatments [20 ▪ ].…”

Course of psychotic experiences and disorders among apprentice traditional health practitioners in rural South Africa: 3-year follow-up study

“…While there is growing evidence which shows that traditional treatments conducted by THPs are either innocuous or beneficial in the field of mental health ( 52 , 53 ), there are also reports which show that some forms of traditional health approaches include treatment methods that are potentially harmful, or that detract from due attention to the human rights of patients with serious mental disorders ( 52 , 54 ). Therefore, we devoted a lot of time and effort to ensure positive collaboration and patient safety with a selected group of THPs in the region.…”