The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

Unge, Christian; Ragnarsson, Anders; Ekström, Anna Mia; Indalo, Dorcus; Belita, Alice; Carter, Jane; Ilako, Festus; Södergård, Björn

doi:10.1080/09540121.2010.534432

Cited by 27 publications

(28 citation statements)

References 19 publications

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“…Most of these students believe in prayers through prayer meetings, gospel teachings and healing sessions by most charismatic prophets. This finding emerges to confirm some previous studies,18, 37, 38 in terms of the strong influence of religion on TRM utilisation.…”

Section: Discussionsupporting

confidence: 92%

Unconventional medical practices among Ghanaian students: A university-based survey

Gyasi

Agyemang-Duah

Mensah

et al. 2017

Journal of Traditional and Complementary Medicine

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Research on unconventional medical practices among students has proliferated lately in the global space, hitherto, little is known explicitly in Ghana. This paper teases out insights for recent utilisation patterns of traditional medical therapies at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. A sample of 754, randomly selected undergraduates were involved in a retrospective cross-sectional survey. Data were analysed using multivariate logistic regression and Pearson's χ2 test with p < 0.05 as significant. Overall prevalence of traditional therapies consumption was 89.1% in the last 12 months. Herbal-based products (67%), prayer healing (15%) and body-mind therapies (11%) were principally used and, accessed through purchases from pharmacy shops (29%) and encounter with faith healers (26%). Although students' knowledge on traditional therapies was acquired through family members (50%) and media (23%), literary materials remained significant information routes for Science related students compared to the Non-science related counterparts (p < 0.001). Pursuing Non-science-related programme [odds ratio (OR) 6.154 (95% confidence interval (CI) 3.745–10.111; p < 0.001)] and having Christian faith [OR 2.450 (95% CI 1.359–4.415; p = 0.003)] were strongly associated with students' traditional therapies use. Although students exhibited positive attitude towards unconventional therapies, there is an urgent need to validate the quality of traditional therapies through randomised clinical trials and regulatory practices to ensure quality control. Health forces should intensify efforts towards intercultural health care system in Ghana.

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Section: Discussionsupporting

confidence: 92%

Unconventional medical practices among Ghanaian students: A university-based survey

Gyasi

Agyemang-Duah

Mensah

et al. 2017

Journal of Traditional and Complementary Medicine

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“…An analysis of 33 patient cohort studies from 13 Africa countries revealed that on average, 60% of patients were retained in ART care after 2 years of initiation [8]; another study has reported retention rates of 75% at 12 months and 67% at 24 months [9]. Reasons for patient attrition from ART care have included the use of traditional medicine [10–12], costs, side effects and stigma [13], and belief in faith healing [12,14,15]. …”

Section: Introductionmentioning

confidence: 99%

Individual and contextual factors influencing patient attrition from antiretroviral therapy care in an urban community of Lusaka, Zambia

Musheke

Bond

Merten

2012

Journal of the International AIDS Society

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IntroductionDespite the relatively effective roll-out of free life-prolonging antiretroviral therapy (ART) in public sector clinics in Zambia since 2005, and the proven efficacy of ART, some people living with HIV (PLHIV) are abandoning the treatment. Drawing on a wider ethnographic study in a predominantly low-income, high-density residential area of Lusaka, this paper reports the reasons why PLHIV opted to discontinue their HIV treatment.MethodsOpened-ended, in-depth interviews were held with PLHIV who had stopped ART (n = 25), ART clinic staff (n = 5), religious leaders (n = 5), herbal medicine providers (n = 5) and lay home-based caregivers (n = 5). In addition, participant observations were conducted in the study setting for 18 months. Interview data were analysed using open coding first, and then interpreted using latent content analysis. The presentation of the results is guided by a social-ecological framework.FindingsPatient attrition from ART care is influenced by an interplay of personal, social, health system and structural-level factors. While improved corporeal health, side effects and need for normalcy diminished motivation to continue with treatment, individuals also weighed the social and economic costs of continued uptake of treatment. Long waiting times for medical care and placing “defaulters” on intensive adherence counselling in the context of insecure labour conditions and livelihood constraints not only imposed opportunity costs which patients were not willing to forego, but also forced individuals to balance physical health with social integrity, which sometimes forced them to opt for faith healing and traditional medicine.ConclusionsComplex and dynamic interplay of personal, social, health system and structural-level factors coalesces to influence patient attrition from ART care. Consequently, while patient-centred interventions are required, efforts should be made to improve ART care by extending and establishing flexible ART clinic hours, improving patient-provider dialogue about treatment experiences and being mindful of the way intensive adherence counselling is being enforced. In the context of insecure labour conditions and fragile livelihoods, this would enable individuals to more easily balance time for treatment and their livelihoods. As a corollary, the perceived efficacy of alternative treatment and faith healing needs to be challenged through sensitizations targeting patients, religious leaders/faith healers and herbal medicine providers.

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“…Similarly, other studies have suggested the use of holy water as a reason for non-adherence to treatment. 10,11,13 HIV-positive participants continue to endorse staying on treatment, in contrast with HIV-negative community members, who for the most part saw no logical reason to stay on treatment with a cure available (in the form of holy water).…”

Section: Discussionmentioning

confidence: 99%

“…21 Data regarding the prevalence of its use is rather scarce, but previous studies have explored reliance on holy water for treating mental illness, HIV, and other ailments. 13,21 However, there is still need for a systematic evaluation of the use of alternative HIV treatment, along with the personal conflict created when having to choose between holy water and treatment, and the alienation caused by community pressure. There appears to be underlying conflict between spiritual messages and medical approaches.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,5,8,9 Limited research from eastern Africa and Ethiopia has suggested that a belief in alternate cures might conflict with adherence to medically necessary treatments. [10][11][12][13] Reasons for default from antiretroviral (ARV) programs in Ethiopia include community pressure and misconception about treatment. 10,12 Improving community knowledge about prevention strategies and medical treatment options, and more interaction with PLWHA, are associated with lower levels of stigma against PLWHA.…”

Section: Introductionmentioning

confidence: 99%

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Community Perception, Misconception, and Discord Regarding Prevention and Treatment of Infection with Human Immunodeficiency Virus in Addis Ababa, Ethiopia

Asgary

Antony

Grigoryan

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Approximately one million persons infected with human immunodeficiency virus (HIV) live in Ethiopia. Socio-cultural factors influence prevention and treatment adherence. We applied a qualitative descriptive approach to evaluate community perception, knowledge, and the role of spiritual factors in regard to HIV. We conducted 14 focus groups with sampling of HIV+ and HIV-participants (n = 52) by using open-ended questions. We coded and analyzed data for major themes. There are misconceptions, including transmission via casual contact, and pervasive beliefs of holy water as a cure. Many HIV-participants believe treatment is ineffective or incompatible with holy water. Most HIV+ participants believe treatment and holy water can be taken together, but experienced either pressure to stop treatment or stigma when taking medications. Participants emphasized the role of spiritual leaders in directing and shaping community perspectives on HIV. Ongoing community education via local initiatives, nation-wide structural and environmental strategies, and efforts tailored toward Ethiopian society to reconcile treatment with faith are crucial.

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The influence of traditional medicine and religion on discontinuation of ART in an urban informal settlement in Nairobi, Kenya

Cited by 27 publications

References 19 publications

Unconventional medical practices among Ghanaian students: A university-based survey

Unconventional medical practices among Ghanaian students: A university-based survey

Individual and contextual factors influencing patient attrition from antiretroviral therapy care in an urban community of Lusaka, Zambia

Community Perception, Misconception, and Discord Regarding Prevention and Treatment of Infection with Human Immunodeficiency Virus in Addis Ababa, Ethiopia

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