Browsing by Subject "Alternative medicine"

Background: Indigenous People around the world experience inequalities in health care. In Brazil, Indigenous inequalities in health are exacerbated by the poor system of health care delivery. The aim of this study is to understand barriers to care as defined from the Indigenous perspective.

Methods: This study was conducted on three Indigenous reserves of the Xavante people in Mato Grosso, Brazil. We utilized a mixed methods approach. In the quantitative portion of the study, we surveyed 50 individuals using an adapted version of the World Health Organization 2002 World Health Survey. Participants for the quantitative survey were recruited from a randomized list of prospective patients for a medical outreach mission. In the qualitative portion of the study, we interviewed 37 individuals, including patients, health care providers, and village chiefs, about their experiences with health care. Participants for the qualitative interviews were recruited randomly from a medical outreach patient listing (Expedicionários da Saúde).

Results: Overall, participants reported dissatisfaction with health-seeking experiences. We identified five barriers to obtaining satisfactory care: lack of transportation, lack of health care services and medication, attitudes of health care workers, lack of culturally appropriate services, and social determinants.

Conclusions: Given an overall sense of dissatisfaction with health care use among indigenous people, future research should focus on identifying interventions to help overcome key barriers to accessing care. Private-public partnerships and other innovative health systems models should be explored to meet the needs of underserved indigenous communities.

Objective: Posttraumatic stress due to trauma exposure in childhood disconnects the mind and body, producing a chronic state of anxiety and ill health that worsens into adulthood. In order to mitigate the harmful effects of trauma experienced by children living in low-resource settings worldwide, evidence-based research on the effect of feasible mind-body interventions to reduce trauma-related symptoms among this vulnerable population is needed. The complementary and alternative medicine (CAM) practice of yoga holds promise as a mind-body approach to child mental and physical wellbeing. The purpose of this preliminary study was to evaluate the effectiveness, feasibility, and acceptability of an 8-week yoga intervention to reduce trauma-related symptoms and emotional and behavioral difficulties among children living in orphanages in Haiti.

Methods: The study design is a case-control study with random assignment to yoga or aerobic dance plus a non-randomized wait-list control group. The UCLA PTSD Reaction Index and the Strengths and Difficulties Questionnaire measured trauma-related symptoms and emotional and behavioral difficulties, respectively. A supplementary questionnaire evaluated participants' experience in the yoga program.

Results: Our main findings include that participation in either 8-weeks of yoga or aerobic dance classes predicted a reduction in trauma-related symptoms and emotional and behavioral difficulties, though not statistically significant (p > .05). The average yoga class attendance was 14.65 (SD = 2.17) out of 16 classes. Ninety-two percent of respondents (N = 26) reported being satisfied with the yoga program and all reported positive changes in wellbeing.

Conclusion: Although the reductions in trauma-related symptoms and emotional and behavioral difficulties among children in the yoga and aerobic dance groups were not statistically significant, positive feedback suggests that yoga is a feasible, acceptable, and enjoyable activity with benefits to child mental and physical health. Further research is needed to evaluate the effect of yoga to relieve trauma-related mental illness among Haitian youth and to promote sustained health into adulthood. Yoga programs designed to improve health and resilience to stress are essential social justice approaches for investing in the wellbeing of our global youth and creating peace within the community at large.

Background: Spirituality and religious practices can motivate proactive health behavior. Although beliefs and practices may lead to different health behaviors, it is important to recognize the contribution of both to allopathic and complementary and alternative health system utilization. There is a lack of empirical research in this area, especially in Honduras, containing a culture rich in spirituality and religious affiliation.

Methods: Ethical review boards at Duke University and the National Autonomous University of Honduras approved the study protocol. A cross-sectional questionnaire survey was administered in urban Tegucigalpa, Honduras, and a final sample of 600 respondents was obtained. The primary independent measures were self-rated spirituality, religious affiliation, church attendance, and private devotion time. The primary outcome measures were: 1) hypothetical health system use, 2) an estimate of actual preventive health system use, 3) an estimate of actual curative health system use, and 4) an estimate of the relative risk of non-adherent behavior using the Medication Adherence Report Scale (MARS).

Results: Among the 600 respondents of the final sample, 499 (83.2%) had seen a physician in the previous year, either for routine check-up or for "sick use" and received some form of medication. Fewer (430/600, 72.0%) had used a complementary and alternative medical system or treatment (excluding prayer used for health reasons). The majority of respondents believed that natural medicine has no side effects (70.2%) and does not interfere with medicine from the physician (62.8%). Nearly all (93.2%) of the respondents felt that prayer was "very important" in curing sickness. Respondents were significantly more likely to prioritize the physician first, compared to natural medicine, if they were older than 25, had less than secondary education, were not a student, knew that natural medicine has harmful side effects, and knew natural medicine can interfere with medicine from a physician. Respondents were significantly more likely to use a combination first if they were 18-24 years old, had at least a secondary education, were unemployed, were students, and thought natural medicine does not interfere with medicine from the physician.

Self-rated spirituality, religious affiliation, church attendance, and private devotion time had significant crude associations with some, but not all, of the outcome measures. There were no significant associations with hypothetical health system use. Nearly two-thirds (65.9%) of those who associated with a specific religion went to a physician for a routine check-up last year compared to 43.0% of those who did not (p<0.001). Among those who attended church, 67.3% went for a routine check-up compared to 44.0% of those who did not attend (p<0.001). In addition, 64.9% of respondents who had a private devotion time, compared to 40.3% of those who did not, had a routine check-up (p<0.001). Self-rated spirituality had only a mild association with having a routine check-up (p<0.05) and using non-prayer complementary and alternative medicine (p<0.05). Those who associated with a religion were more likely to have received some form of medicine from an allopathic physician last year (80.7% vs. 61.3%, p<0.001). Likewise, 82.0% percent of churchgoers compared to 62.7% of those that did not go to church received medicine (p<0.001). Finally, 58.9% of those with a daily private devotion time, compared to 44.2% of those without one, reported adherent behavior (p<0.01).

Conclusion: Self-rated spirituality and religious involvement are significantly associated with the utilization of the preventive and curative allopathic health systems and adherence to medication in Tegucigalpa, Honduras. These findings deserve further consideration and have implications in both health policy and patient care in Honduras, a country with a thriving spiritual and religious culture.

Background: Traditional medicine use is increasingly recognized as a common and important component of healthcare globally. Our study aim was therefore to identify the commonly used traditional medicines in Moshi, Tanzania, the factors influencing their use and associations between traditional medicine use & prevalence of chronic diseases. Methods: We performed a secondary data analysis of a mixed methods study in Moshi, comprising 42 extended interviews and 5 focus group discussions with key informants, and cross-sectional household survey using interviewer-administered questionnaires and field-based diagnostic tests for CKD, diabetes, hypertension and HIV. Results: We identified 168 traditional medicines, of which 15 (8.9%) and 5 (3%) were used to treat chronic diseases and CKD, respectively. Participants reported seeking healthcare advice from medical doctors (97%), family members (52%), pharmacists (24%) and friends or neighbors (14%). In a fully adjusted model, CKD patients were more likely than the non-CKD population to report a history of traditional medicine use (AOR=1.99; p=0.04), and family tradition (OR=1.97), difficulty finding a medical doctor (OR=2.07) and fewer side effects with traditional medicines (OR=2.07) as their reasons for preferring traditional medicines to hospital medicines. Conclusions: Traditional medicine use is high in Moshi, and more so among the CKD population. A history of traditional medicine use is associated with the prevalence of CKD in Moshi. Most of these traditional medicines have biologically active substances that could potentially be developed into therapeutic and prophylactic therapies for CKD, and CKD-associated co-morbidities.