Collaboration between traditional health practitioners and biomedical health practitioners: Scoping review.

BACKGROUND:  Collaboration between traditional health practitioners (THPs) and biomedical health practitioners (BHPs) is highly recommended in catering for pluralistic healthcare users. Little is known about bidirectional collaborations at healthcare service provision level. AIM:  To map global evidence on collaboration attempts between THPs and BHPs between January 1978 and August 2023. METHOD:  We followed the Arksey and O'Malley framework in conducting this scoping review. Two reviewers independently screened articles for eligibility. A descriptive numerical and content analysis was performed on ATLAS.ti 22. A narrative summary of the findings was reported using the PRISMAScR guideline. RESULTS:  Of the 8404 screened studies, 10 studies from 12 articles were included in the final review. Studies came from America (n = 5), Africa (n = 2), China (n = 2) and New Zealand (n = 1). Eight studies reported case studies of bidirectional collaboration programmes, while two studies reported on experimental research. All collaborations occurred within biomedical healthcare facilities. Collaboration often entailed activities such as relationship building, training of all practitioners, coordinated meetings, cross-referrals, treatment plan discussions and joint health promotion activities. CONCLUSION:  This study confirmed that practitioner-level collaborations within healthcare are few and sparse. More work is needed to move policy on integration of the two systems into implementation. There is a need to conduct more research and document emerging collaborations.Contribution: This research illuminates the contextual challenges associated with sustaining collaborations. The data would be important in informing areas that need strengthening in the work towards integration of THPs and BHPs.

Has Treatment Seeking Behaviour Changed in People Living with Epilepsy? Experience of People Living with Epilepsy Attending Adult Neurology Clinics in Enugu.

BACKGROUND: Over the years efforts has been made through public health education to change the knowledge, attitude and practice of epilepsy and seizures among the populace in Nigeria. One surrogate method of reviewing the impact of these educational interventions includes changes in treatment-seeking behavior of People Living With Epilepsy and the reasons for their choices of treatment. METHODS: This was a cross-sectional descriptive study. Data were collected from People Living With Epilepsy attending the medical outpatient clinics in two tertiary hospitals in Enugu, Enugu State southeast Nigeria. RESULTS: A total 276 people living with epilepsy were recruited with a mean age of 30.1 years and a median age of 25 years. After the onset of epilepsy, 76(27.5%) and 70(25.4%) visited general hospitals and teaching hospitals respectively, while prayer houses and traditional healing centers were first visited by 54(19.6%) and 40(14.5%) respectively. As a second choice of care 9(3.3%) and 13(4.7%) visited prayer houses and traditional healing centers. Only 42(15.2%) selected their treatment center because they were confident of getting a cure however, this was highest for those that visited traditional healing centers 11(27.5%). The age of onset of epilepsy positively correlated with selecting orthodox treatment at the choice of care, while occupational status negatively correlated with selecting orthodox care at the same period. CONCLUSIONS: Health care seeking behaviors among PLWE in Southeast Nigeria might have changed over the years as more people living with epilepsy were more likely to select orthodox treatment compared to non-orthodox means of treatment.

CONTEXTE: Au fil des ans, des efforts ont été déployés par le biais de l'éducation en santé publique pour changer les connaissances, les attitudes et les pratiques concernant l'épilepsie et les crises d'épilepsie parmi la population au Nigeria. Une méthode indirecte pour examiner l'impact de ces interventions éducatives comprend les changements dans le comportement de recherche de traitement des personnes vivant avec l'épilepsie et les raisons de leurs choix de traitement. MÉTHODES: Il s'agit d'une étude descriptive transversale. Les données ont été collectées auprès de personnes vivant avec l'épilepsie fréquentant les cliniques de consultations externes médicales dans deux hôpitaux tertiaires à Enugu, dans l'État d'Enugu, au sud-est du Nigeria. RÉSULTATS: Au total, 276 personnes vivant avec l'épilepsie ont été recrutées, avec un âge moyen de 30,1 ans et un âge médian de 25 ans. Après le début de l'épilepsie, 76 (27,5 %) et 70 (25,4 %) ont consulté respectivement des hôpitaux généraux et des hôpitaux universitaires, tandis que les lieux de prière et les centres de guérison traditionnelle ont été les premiers consultés par respectivement 54 (19,6 %) et 40 (14,5 %). Comme deuxième choix de soins, 9 (3,3 %) et 13 (4,7 %) ont consulté des lieux de prière et des centres de guérison traditionnelle. Seuls 42 (15,2 %) ont choisi leur centre de traitement parce qu'ils étaient confiants d'obtenir une guérison, cependant, ce taux était le plus élevé pour ceux qui ont consulté les centres de guérison traditionnelle (11 soit 27,5 %). L'âge de début de l'épilepsie était positivement corrélé avec la sélection d'un traitement orthodoxe comme choix de soins, tandis que le statut professionnel était négativement corrélé avec la sélection de soins orthodoxes au même moment. CONCLUSIONS: Les comportements de recherche de soins parmi les personnes vivant avec l'épilepsie dans le sud-est du Nigeria ont peut-être changé au fil des ans, car davantage de personnes vivant avec l'épilepsie étaient plus susceptibles de choisir un traitement orthodoxe par rapport aux moyens de traitement non orthodoxes. MOTS-CLÉS: Épilepsie, Comportement de recherche de soins, Guérisseurs traditionnels, Lieux de prière, Médecine orthodoxe, sud-est du Nigeria.

Traditional healer support to improve HIV viral suppression in rural Uganda (Omuyambi): study protocol for a cluster randomized hybrid effectiveness-implementation trial.

BACKGROUND: Rural African people living with HIV face significant challenges in entering and remaining in HIV care. In rural Uganda, for example, there is a threefold higher prevalence of HIV compared to the national average and lower engagement throughout the HIV continuum of care. There is an urgent need for appropriate interventions to improve entry and retention in HIV care for rural Ugandans with HIV. Though many adults living with HIV in rural areas prioritize seeking care services from traditional healers over formal clinical services, healers have not been integrated into HIV care programs. The Omuyambi trial is investigating the effectiveness of psychosocial support delivered by traditional healers as an adjunct to standard HIV care versus standard clinic-based HIV care alone. Additionally, we are evaluating the implementation process and outcomes, following the Consolidated Framework for Implementation Research. METHODS: This cluster randomized hybrid type 1 effectiveness-implementation trial will be conducted among 44 traditional healers in two districts of southwestern Uganda. Healers were randomized 1:1 into study arms, where healers in the intervention arm will provide 12 months of psychosocial support to adults with unsuppressed HIV viral loads receiving care at their practices. A total of 650 adults with unsuppressed HIV viral loads will be recruited from healer clusters in the Mbarara and Rwampara districts. The primary study outcome is HIV viral load measured at 12 months after enrollment, which will be analyzed by intention-to-treat. Secondary clinical outcome measures include (re)initiation of HIV care, antiretroviral therapy adherence, and retention in care. The implementation outcomes of adoption, fidelity, appropriateness, and acceptability will be evaluated through key informant interviews and structured surveys at baseline, 3, 9, 12, and 24 months. Sustainability will be measured through HIV viral load measurements at 24 months following enrollment. DISCUSSION: The Omuyambi trial is evaluating an approach that could improve HIV outcomes by incorporating previously overlooked community lay supporters into the HIV cascade of care. These findings could provide effectiveness and implementation evidence to guide the development of policies and programs aimed at improving HIV outcomes in rural Uganda and other countries where healers play an essential role in community health. TRIAL REGISTRATION: ClinicalTrials.gov NCT05943548. Registered on July 5, 2023. The current protocol version is 4.0 (September 29, 2023).

Experiences of injured patients referred to higher levels of care after initial assessment and management at non-tertiary hospitals in Ghana.

Background: The experiences of trauma patients referred from Ghanaian non-tertiary hospitals for definitive care at higher levels is not well-known. Understanding the motivations of injured patients who do not attend their referral for definitive management may inform interventions to improve injury outcomes. Methods: This study is a follow-up survey of participants of a larger study involving initial management of injured patients presenting to 8 non-tertiary hospitals in Ghana from October 2020 to March 2022. Injured patients referred to higher levels of care were surveyed by phone using a structured questionnaire and patients who could not be reached were excluded. The main outcome was referral non-attendance and differences between patients who attended the referral and those who did not were determined with chi squared tests. Variables with intergroup differences were included in a multivariable logistic regression. Open-ended survey responses were analyzed using thematic content analysis. Results: Of 335 referred patients surveyed, 17 % did not attend the referral. Factors associated with referral non-attendance included being male (Adjusted odds ratio (AOR)=2.70, p = 0.013), sustaining a fracture (AOR=2.83, p = 0.003), and having less severe injury (AOR 2.84, p = 0.017). Primary drivers of referral non-attendance included financial problems (59 %), family influence (45 %), and lack of transportation (20 %). The majority of patients (77 %) not attending the referral sought treatment from traditional healers, citing lower cost, faster service, and a perception of equivalent outcomes. Reported facilitators of referral attendance included positive hospital staff experiences and treatment while barriers included higher hospital costs, lack of bed space, and poor interhospital communication. Conclusions: An important proportion of injured patients in Ghana do not attend referrals for definitive management, with many seeking care from traditional healers. Our study identified possible targets for interventions aimed at maintaining the continuum of hospital-based care for injured patients in order to improve outcomes.

Traditional healers' knowledge and infection control practices related to HIV in Bukavu City, Democratic Republic of the Congo.

BACKGROUND: Patients with HIV consult traditional healers (THs). These THs can both delay care for people living with HIV (PLHIV) and transmit HIV through poor infection control practices. The main objective of this study was to evaluate knowledge and practices of THs regarding HIV in Bukavu. METHODS: A cross-sectional study using quantitative approach was carried out among 71 THs in Bukavu City. The collected data included the following topics: personal and socio-demographic characteristics, HIV knowledge, and infection control practices. Descriptive statistics, independent-samples T-test or F-test, and multiple linear regression were used to analyze the data with a p-value < 0.05. RESULTS: The THs' mean age was 49.2 ± 11.2 years, and the majority were aged 40 to < 60 years. Males constituted 88.7% of THs with a male-to-female ratio of 7.9. In general, 47.9% of study participants had poor knowledge about HIV/AIDS infection, 45.1% of them had fair knowledge, and only 7.0% had good knowledge. Overall, 43.7% of THs had poor infection control practices, 52.1% of THs had fair practices, and only 4.2% of participants had good practices. Results of multiple linear regression analysis revealed that none of the personal and demographic variables studied were significant predictors of their knowledge about HIV/AIDS (p > 0.05). In terms of practices, two variables were significant predictors of infection control practices: living in Ibanda and receiving training in taking care of HIV/AIDS. CONCLUSION AND RECOMMENDATIONS: The study revealed that THs' knowledge about HIV infection was insufficient and that they had poor infection control practices. Formal standardized training on HIV infection should be organized for all THs so that they can always refer their patients to modern, reliable antiretroviral therapy (ART) clinics and reduce the risk of occupational exposure in their practices. Although PPE's assistance for THs is required in terms of protective measures, the province health authority must also oversee infection control procedures at THs' offices.

Knowledge and practices of traditional management of child malnutrition and associated pathologies in Benin.

BACKGROUND: Child malnutrition is a major public health challenge, affecting millions of children worldwide, with alarming proportions of children under five in Benin. The complexity of managing this condition is increased by its potential association with opportunistic pathologies. An interesting approach arises from the use of medicinal plants, to address child malnutrition and its associated pathologies. This study aimed to document the knowledge and practices of Beninese mothers and traditional practitioners with regard to the use of medicinal plants to treat child malnutrition and associated diseases. METHODS: A total of 844 Beninese mothers and 201 traditional healers were surveyed between March 2022 and August 2023 in the communes of Karimama, Bopa and Za-Kpota in Benin. The respondents' knowledge of child malnutrition and associated pathologies was explored. The ethnobotanical data collected from the subjects concerned the medicinal recipes used to treat child malnutrition, the medicinal plants that make them up and the methods of use. These data were analyzed using ethnobotanical indices such as the Informant Consensus Factor, the frequency of citation of medicinal recipes types and medicinal plants, and the contribution of plants to medicinal recipes. RESULTS: All respondents cited a total of 82 plant species used to treat child malnutrition and associated diseases. These plants were grouped into 37 botanical families, the most common of which were Fabaceae, Malvaceae and Annonaceae. The leaves were the most commonly used part of the plant species identified. The mothers shared 122 medicinal recipes, ranging from recipes based on a single plant to more complex compositions involving five plants. The most notable plants were Moringa oleifera Lam, Phyllanthus amarus Schumach & Thonn, Senna siamea (Lam.) H.S.Irwin & Barneby, Carica papaya L. and Ocimum gratissimum L. Traditional healers provided 52 plants in 71 recipes, with Moringa oleifera featuring prominently in both single-plant and multiplant formulations. CONCLUSION: This study made it possible to constitute a rich base of medicinal recipes used against malnutrition and associated pathologies, with the preponderant involvement of certain plant species. It is therefore necessary to deepen research on these different identified species in order to scientifically assess their potential.

Traditional healers' perception on scabies causation and management in Ghana.

INTRODUCTION: Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. METHODS: A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. RESULTS: Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. CONCLUSION: The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.

Irvingia gabonensis baill. (African Mango): A comprehensive review of its ethnopharmacological significance, unveiling its long-standing history and therapeutic potential.

ETHNOPHARMACOLOGICAL RELEVANCE: Irvingia gabonensis (Aubry-Lecomte ex O'Rorke) Baill. (IG) is a multipurpose tree native to tropical Africa such as Equatorial Guinea, Nigeria, Gabon, and Cameroon with high ethnomedicinal values. AIM OF THE STUDY: This review emphasizes the ethnopharmacological significance, phytochemical, and functional properties of African mango, focusing on its potential for human health and industrial applications. MATERIALS AND METHODS: Literature published on IG was traced by different databases, including the Egyptian Knowledge Bank database (EKB), ScienceDirect, PubMed, Google Scholars, Research Gate, Web of Science, Elsevier, and Scopus. Numerous keywords were used to achieve an inclusive search in the databases, like 'African Mango', 'Bush Mango', 'Irvingia gabonensis', 'Wild Mango', 'Dika Nut', 'Phytochemistry', 'Traditional uses', 'Functional foods', 'Polyphenols', 'Ogbono', 'Ellagic acid and its derivatives', and 'Pharmacological activities'. RESULTS: Different parts of IG have been employed in traditional medicine and recorded a great success. The ripe fruit pulp was consumed fresh or processed into juice and wine documented for anti-diarrheal, anti-diabetic, anti-ulcer, hepatoprotective, antimicrobial, and anti-inflammatory properties. The kernels, which are widely traded and incorporated into traditional dishes, remain an integral part of culinary traditions. Seeds have folkloric uses for weight loss and are popular as blood thinners and anti-diabetics. Where the bark is reported for dysentery, colic, scabies, toothache, and various skin conditions. In Senegal, the stem bark is employed for gonorrhea, hepatic disorders, and gastrointestinal ailments. The leaves possess the potential to enhance renal and hepatic functions, safeguarding these vital organs against the detrimental effects of toxic substances. Pulp is rich in vitamin C, carbohydrates, and proteins. Oil is the major constituent of the seed, which is mainly composed of myristic and lauric acids. The defatted extracts are characterized by flavonoid glycosides and ellagic acid derivatives. Despite their widespread use, IG extracts are still inadequately characterized phytochemically and merit further investigation within the realm of scientific research. Encouragingly, toxicity studies have demonstrated the relative safety of IG extract at the administered doses. CONCLUSION: The review extends our knowledge of the health benefits of IG, where these effects could be attributed to the phytochemicals present.

Religious and Medical Pluralism Among Traditional Healers in Johannesburg, South Africa.

Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted with 18 THPs in Johannesburg, South Africa between January and May, 2022. Interviews were transcribed and translated into English. Data were managed using NVivo 12 software and thematically analyzed. The majority of THPs interviewed indicated that initiation as a THP was almost always preceded by a sickness accompanied by dreams/visions that represented an "ancestral calling" to become a healer. Most THPs also trained as both sangomas-who healed according to traditional beliefs-and prophets-who healed according to Christian beliefs. This reflects a syncretic relationship between traditional African beliefs and Christianity. However, not all churches are accepting of traditional beliefs and subsequently these THPs are members only at non-Pentecostal AIC churches who blend both African and Christian practices. Similar to these forms of religious pluralism melding Christianity and traditional beliefs, many THPs also often practice medical pluralism, mixing Western treatments with traditional practices/medicines. THPs are able to adapt elements of Western and African beliefs into healing practices that span multiple religious and medical fields. Thus, collaborative and decentralized healthcare services may be highly acceptable among such a pluralistic community.

Pathways to care for psychosis in Malawi.

People with psychosis in Malawi have very limited access to timely assessment and evidence-based care, leading to a long duration of untreated psychosis and persistent disability. Most people with psychosis in the country consult traditional or religious healers. Stigmatising attitudes are common and services have limited capacity, particularly in rural areas. This paper, focusing on pathways to care for psychosis in Malawi, is based on the Wellcome Trust Psychosis Flagship Report on the Landscape of Mental Health Services for Psychosis in Malawi. Its purpose is to inform Psychosis Recovery Orientation in Malawi by Improving Services and Engagement (PROMISE), a longitudinal study that aims to build on existing services to develop sustainable psychosis detection systems and management pathways to promote recovery.

Traditional healing in Kisii County, Kenya: a personal narrative.

This article describes the author's experiences growing up in a family of traditional healers, an account of early guidance by her grandmother, a severe illness that influenced her to become a healer and the values that are central to her own work as a traditional healer who specialises in treatment of mental health problems. The impact of colonisation on traditional healing practices in Africa is highlighted.

Therapeutics to Treat Psychiatric and Neurological Disorders: A Promising Perspective from Algerian Traditional Medicine.

Ancient people sought out drugs in nature to prevent, cure, and treat their diseases, including mental illnesses. Plants were their primary source for meeting their healthcare needs. In Algeria, folk medicine remains a fundamental part of the local intangible knowledge. This study aims to conduct a comprehensive ethnomedicinal investigation and documentation of medicinal plants and the different plant formulations traditionally used in Algeria for the treatment of pain, psychiatric, and neurological disorders. It also intends to improve the current knowledge of Algerian folk medicine. Several scientific databases were used to accomplish this work. Based on this investigation, we identified 82 plant species belonging to 69 genera and spanning 38 distinct botanical families used as remedies to treat various psychological and neurological conditions. Their traditional uses and methods of preparation, along with their phytochemical composition, main bioactive constituents, and toxicity were noted. Therefore, this review provides a new resource of information on Algerian medicinal plants used in the treatment and management of neurological and psychological diseases, which can be useful not only for the documentation and conservation of traditional knowledge, but also for conducting future phytochemical and pharmacological studies.

Medicinal plants for treatment of diarrhoeal diseases among under-five children: experience from traditional healers in North-eastern Tanzania.

BACKGROUND: Right through history, humans have relied heavily on plants for sustenance and the healing of different ailments. One of the long-standing traditions that communities have inherited from earlier generations is the use of herbal medicines for the treatment of paediatric ailments, including diarrhoea. This study showcased medicinal plants used by traditional healers for the treatment of diarrhoeal diseases among under-five children in North-eastern Tanzania. METHODS AND DESIGN: A qualitative research approach and a narrative research design were employed. The research was carried out in the districts of Korogwe and Handeni in North-eastern Tanzania, with 52 in-depth interviews performed with participants (traditional healers). Purposive sampling method was used to select participants, and a thematic analysis framework was used to analyze the data. RESULTS: Study results indicate that traditional healers had enormous insights and were well informed about medicinal plants that were perceived to be efficacious in treating diarrhoeal diseases among under-five children. A total of 54 medicinal plants were reported by the participants to be effective in healing diarrhoeal diseases among under-five children. However, out of 54 medicinal plants, 15 were predominantly disclosed by the majority of participants. Those medicinal plants include Psidium guajava, Rhus natalensis, Ozoroa insignis, Tamarindus indica, Ocimum suave, Combretum molle, Zanha africana, Solanum incanum, and Ximenia americana. Other medicinal plants mentioned by most participants include, Ochna holstii, Elaeodendron schlechterianum, Albizia anthelmintica, Commiphora pteleifolia, Salacia stuhlmanniana, and Zenkerella grotei. CONCLUSION: All traditional healers seemed to have a clear understanding regarding the medicinal plants that were used to treat diarrhoeal diseases among under-five children. The participants acknowledged to treating under-five children with diarrhoeal diseases using herbal medications on multiple occasions. The findings of this study should inspire more in-depth botanical research to determine whether the medicinal plants reported in this study have anti-diarrhoeal properties.

Community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania.

BACKGROUND: The demand for herbal medicines continues to increase globally. However, community perceptions on their effectiveness and factors influencing their use have not been extensively investigated, notably in the Tanga Region, North-eastern Tanzania, where their use in treating various diseases, including paediatric diarrhoea, has flourished. According to studies, Tanga Region has a high prevalence of diarrhoea among under-five children. This study explored community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania. METHODS: A qualitative approach and a narrative design were employed by the present study since they had the potential to reveal unrecognized or unreported research problems. Focus group discussions and in-depth interviews were used to facilitate data collection from June 2022 to February 2023. The methods were chosen since they are the most common sources of qualitative data in health research. Purposive sampling method was used to select 247 participants, which included 171 caretakers, 52 traditional healers, and 24 paediatric health workers. Interviews were conducted until the saturation point was reached. The purposive technique was considered since it was a method that enabled the researcher to select participants who were knowledgeable about the study topic. Data analysis was performed using thematic analysis. RESULTS: Economic hardship, culture and heritage, superstitious beliefs, failure to recover after receiving hospital medication, easy accessibility of herbal medicines, and long distance to the health facility were the factors perceived to be potentially associated with persistent use of herbal medicines among caretakers. The majority of participants believed that herbal treatments were harmless and effective in treating diarrhoea. CONCLUSION: Superstitious beliefs, culture, and heritage were the primary justifications for using herbal medicines. It is vital for the relevant authority to educate the community on the risk of using unproven herbal medicines in order to diminish the effects that may arise from using uninvestigated herbs. As things stand, the use of herbal medications will continue owing to their relevance to the lives of people in the study setting.

Ethnoveterinary practises of medicinal plants used for the treatment of different cattle diseases: A case study in East Khasi Hill district of Meghalaya, North East India.

Introduction: For generations, the inhabitants of Meghalaya have relied on medicinal plants to maintain the health of their livestock and treat various illnesses that may afflict their animals. Due to the lack of survey for use and documentation, these plants have never been undertaken. Therefore, it is imperative to explore the diversity, utilization, and phytochemical profile of these plants and quantitatively analyse the data to identify important medicinal plants. By doing so, we can better understand the potential of these plants for developing novel drugs. Methods: Frequent field trips were made for the collection of ethnoveterinary data of medicinal plants from local animal-keepers, traditional healers (THs) and inhabitants of different age groups. This information was gathered through semi-structured interviews, individual discussions, direct field-use observation, and questionnaires. A total of 52 informants (35 females and 17 males) were interviewed from seven rural villages and the information obtained from them were quantitatively analysed using the informant consensus factor (ICF), and fidelity level (FL). Additionally, for each documented plant, available published literature was extensively surveyed to identify the presence of bioactive chemical compounds responsible for their therapeutic effects. Results: During the present study, a total 96 plants, distributed into 87 genera and 43 families were identified and recorded for their use in ethnoveterinary practices against more than 25 diseases. Out of the recorded plant species, the Fabaceae family was found to be the most dominant with seven species, followed by Poaceae and Lamiaceae with six species each, and Moraceae with five species. The leaves (50.00%) and seeds (12.50%) were the most frequently used plant parts, while the paste (30 species) was the common mode of application. Aegle marmelos Correa exhibited a fidelity level (FL) of 100% for indigestion, while Tagetes erecta L. had a fidelity level of 94.11% for wound treatment, making them the most promising candidates for further study. The highest FIC value of 1.00 was recorded for the treatment of neurological disorder (1.00), followed by foot and mouth disease (FIC 0.91), which depicted that some species were frequently utilized to treat multiple livestock ailments. Conclusion: The study presents trustworthy information about medicinal plants and their associated indigenous ethnoveterinary knowledge. It has been scientifically proven that these plants contain bioactive compounds responsible for their therapeutic properties. However, this knowledge is in danger of being lost due to factors like socioeconomic changes, environmental and technological alterations, and lack of interest from younger generations. Therefore, it is essential to document this empirical folklore knowledge systematically and take measures to protect and conserve it.

Women health providers: materials on cures, remedies and sexuality in inquisitorial processes (15th-18th century).

Background: The first inquisitorial trials were against Muslims and Jews. Later, they focused on women, especially caregivers. Progressively, they were linked to witchcraft and sorcery because of their great care, generational and empirical knowledge. The historiography of health in the 15th-18th centuries still has important bibliographical and interpretative gaps in the care provided by women. Objective: To analyse the care provided by healers as health providers, accused by the Inquisition, justifying the importance of nursing in the diversity of community care in the 15th-18th centuries. Method: A scoping review was conducted following the Dialectical Structural Model of Care (DSMC). A database search was conducted for the period 2013-2022. Bibliographic and legislative resources were used. Cases and convictions from Castilla la Nueva were found in the National Historical Archive and the Diocesan Archive of Cuenca. Results: The concepts of healer, witch and sorceress envolved during the study period. They reflect and reveal the collective imaginary of the social structure. They had healing laboratories, practised psychological and sexual care. They used to accompany their therapeutic action with prayers and amulets. They shared their professional activity with their main denouncers, doctors, apothecaries and priests. They were usually women in socially vulnerable situations, who did not conform to social stereotypes. Conclusions: They were predecessors of today's nursing, they overcame socio-cultural difficulties, although they were condemned for it. Healers did not manage to regulate their profession, but they acted as agents of health in a society that demanded them while participating in the "witch-hunt".

Beliefs and attitudes of traditional healers regarding epilepsy in Cameroon.

INTRODUCTION: People living with epilepsy suffer from stigmatization, overprotection, or exclusion, thus, part of these population in developing countries uses traditional medicine as a first resort. METHODS: We prospectively conducted a study to determine the knowledge, attitudes, and practices (KAP) of traditional healers (THs) concerning epilepsy. Over a 9-month period, we included 208 THs practicing in the Littoral, Center and West regions of Cameroon who agreed to participate in the study. The THs were interviewed using a standardized questionnaire. Data were analyzed using Epi Info version 7.2 software. RESULTS: Two-hundred and eight THs were recruited, with a mean age ± standard deviation (SD) of 49.9 ± 11.4 years, and 169 (81.2%) were male. Primary 77(37.0%) and secondary 67(32.2%) levels of education were the most represented, and most of the THs had more than 10 years of professional experience. One hundred and forty-one TH (68,7%) had poor knowledge about epilepsy. The independent factors associated with poor knowledge were female sex, Muslim religion, and marital status of cohabitation. One hundred and eighty-four THs (88.4%) had a good attitude and practices toward people with seizures. Factors independently associated with poor practices and attitude were rural residence, Muslim religion, and education level. CONCLUSION: Our result confirmed that THs had poor knowledge about epilepsy but good attitudes and practices about epilepsy. THs were in favor of future collaboration with modern medicine in the care of people living with epilepsy.

Utilisation of traditional healers among older people living with HIV in South Africa: a WHO SAGE well-being of older people study.

BACKGROUND: Within the African region, there are an estimated 8 million people living with HIV (PLHIV) in South Africa. Seeking healthcare services from traditional healers (TH) is one of the alternative and complementary approaches to HIV/AIDS treatment. Identifying the associated factors of TH utilisation among older PLHIV is crucial in developing healthcare interventions that cater to the unique needs of this vulnerable group. This study investigated the factors associated with TH utilisation among older PLHIV. METHODS: We studied 516 older PLHIV using data from the WHO SAGE Well-Being of Older People Study (2011-2013). Chi-square, bivariate and multivariate logistic regression were computed in STATA Version 14. The results were presented with both crude and adjusted odds ratio (AOR) and at 95% confidence interval (CI). RESULTS: Of the 516 participants, 15.89% utilised TH. The major reason for TH utilisation among older PLHIV was the perception of receiving better healthcare services from TH (51.2%) and the flexibility to pay with goods instead of money (14.6%). The factors associated with TH utilisation were age [AOR = 0.05; CI 0.01, 0.37], being hypertensive [AOR = 2.07; CI 1.04, 4.11], and having more than four servings of fruits [AOR = 10.64; CI 2.95, 38.34]. TH utilisation was significantly lower among those who visited the clinic once or twice [AOR = 0.17; CI 0.05, 0.63], three to six times [AOR = 0.16; CI 0.05, 0.56], and more than 6 times [AOR = 0.09; CI 0.03, 0.34] compared to those who had no clinic visits. CONCLUSION: In conclusion, a low proportion of TH utilisation was reported among older PLHIV in South Africa. TH utilisation is associated with age, hypertension status, frequency of clinic visits and fruit servings consumed. Our study suggests that being hypertensive was a motivating factor for older PLHIV to utilise TH. Therefore, it is imperative for the South African health department to integrate the services of TH into the mainstream health system to manage non-communicable diseases, particularly hypertension, among older PLHIV.

Dementia in South Africa: A Situational Analysis.

There is a need in South Africa to understand the status of available care and support to strengthen responses to dementia. This study provides a situational analysis of the current provisions of health, care and support for older persons, people living with dementia and their families in South Africa. It is a first step towards describing the landscape of needs and services available, and provides an evidence base to inform priority-setting for strengthening responses to dementia in South Africa. This situational analysis was conducted in three phases: (1) a desk review guided by a comprehensive topic guide which includes the WHO's Global Dementia Observatory indicators; (2) multi-sectoral stakeholder interviews to verify the secondary sources used in the desk review, and to identify gaps and opportunities in policy and service provisions; and (3) a SWOT-analysis examining the strengths, weaknesses, opportunities and threats in current care and support provisions in South Africa. Our findings highlight the gaps and opportunities with current service provision and show how structural factors create barriers to diagnosis, support, and care. There is an urgent need for intersectoral policy responses to support and strengthen current health, social care, and long-term support systems so that people living with dementia and their families can live and age well. This paper forms part of a larger study on strengthening responses to dementia (The STRIDE project).

A qualitative study to explore the ethnomedicine practices towards hepatitis among the Irula traditional healers in Tamil Nadu, India.

Introduction: Irulas are known for their traditional medicine and healing practices. Ethnomedicine primarily describes the traditional medical approaches that take consideration of the cultural perspectives on health, illness, disease while addressing the delivery of healthcare and therapeutic modalities. The current study explores the ethnomedical practices towards hepatitis among the Irula traditional healers in Tamil Nadu. Methodology: A Community-based in-depth interview (IDI) study was conducted among eight traditional healers (5 males and 3 females) from Irula settlements in Dharmapuri, Kancheepuram, and Chengalpattu districts. Apart from traditional healers, 11 Irula adults were interviewed to understand their cultural perspectives on health and illness. Results: The major themes that emerged from the codes were the perception towards traditional healing and the process of treatment on hepatitis, the list of important conditions treated by the traditional healers, and the list of medicinal plants used for treating people. Conclusion: This qualitative study highlights the voices of the Irula tribal community and offers a rich source of information about ethnomedicine practices towards hepatitis among the Irula traditional healers in Tamil Nadu, India.