Using Qualitative Methods to Explore Lay Explanatory Models, Health-Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia

Abstract

BackgroundPodoconiosis (endemic non-filarial elephantiasis) is a chronic, non-infectious disease resulting from exposure of bare feet to red-clay soil in tropical highlands. This study examined lay beliefs about three under-researched aspects of podoconiosis patients’ care: explanatory models, health-seeking behaviours and self-care.MethodsIn-depth interviews and focus group discussions were undertaken with 34 participants (19 male, 15 female) between April-May 2015 at podoconiosis treatment centres across East and West Gojjam regions in north-west Ethiopia.ResultsExplanatory models for podoconiosis included contamination from blood, magic, soil or affected individuals. Belief in heredity or divine punishment often delayed clinic attendance. All participants had tried holy water treatment and some, holy soil. Herbal treatments were considered ineffectual, costly and appeared to promote fluid escape. Motivators for clinic attendance were failure of traditional treatments and severe or disabling symptoms. Patients did not report self-treatment with antibiotics. Self-care was hindered by water being unavailable or expensive and patient fatigue.ConclusionA pluralistic approach to podoconiosis self-treatment was discovered. Holy water is widely valued, though some patients prefer holy soil. Priests and traditional healers could help promote self-care and “signpost” patients to clinics. Change in behaviour and improving water access is key to self-care.

Factors affecting access to primary health care services for persons with disabilities in rural areas: a “best-fit” framework synthesis

“…Due to the perceived low quality of services some clients resorted to alternative care, including traditional and faith-based healers [47, 49, 50, 54]. Interestingly, a paper stressed that when patients exhausted traditional treatments, Western medical clinics became their last resort [52]. One article also reported that others also rely on medical shops or travel to major cities to seek care [62].…”

“…Importantly, we noted that rural residents with disabilities opted for Western medical facilities after exhausting the traditional healing system. This pluralistic approach is a common health seeking behaviour of many rural residents [52]. Indeed, there have been calls on integrating traditional healing system into modern medical practices [52, 79].…”

“…This pluralistic approach is a common health seeking behaviour of many rural residents [52]. Indeed, there have been calls on integrating traditional healing system into modern medical practices [52, 79]. However, the role of traditional and faith-based practitioners is unclear from this review.…”

Balance, Capacity, and the Contingencies of Everyday Life: Narrative Etiologies of Health Among Women in Street-Based Sex Work

“…Anthropological and sociological research into the meanings and functions of health among different sociocultural groups reveals its multivocality as a symbol of life well-lived (Hunt, 1998; Jensen, 2013), socioeconomic change (Banks et al, 2016; Brodwin, 1996; Scheper-Hughes, 1992), and something created from multiple knowledge and healing systems (Badone, 2008; Broom et al, 2013). Our participants likewise viewed health in multivocal terms, including drug use, which was not always seen as a “bad” activity.…”

'I should not feed such a weak woman'. Intimate partner violence among women living with podoconiosis: A qualitative study in northern Ethiopia

“…water and healthcare), but also on the effects of restricted decision-making of the affected women. Self-care is known to be a key determinant of outcomes in podoconiosis [35] and, as demonstrated, it is largely impeded by IPV. In turn, the negative impacts of IPV and podoconiosis on family members help perpetuate the conditions of poverty that often determine the onset of the disease.…”