Introduction

Question 1

The healing art is an all-encompassing activity ranging from the services of the orthodox medical practitioners to those of the unorthodox healers.
True or false
What did Nabofa observe
What are the two traditional disease causation theories

Answer 1

True

Nabofa (1996) observes that while the orthodox healers use techniques that are based upon scientific investigations and applications, the traditional healers rely on the intuitive insight and faith of both the healer and his patients, which may defy empirical and scientific verifications.

• Two broad domains of ethnological theories are identifiable in the ethno medical system
• Naturalistic ethnologies:
• Magico- religious domain:

Question 2

Wtat are naturalistic ethnologies

Name three places sickness can result from in this theory

Answer 2

In this ethological theory, aliments are ascribed to causes pertaining to the empirical domain and exclude the intervention of a supernatural agent. Hence sickness may result from:

from:
•External factors – such as a faulty interaction with the environment, e.g. drinking polluted water, eating contaminated or bad food, atmospheric charges, inhaling dusts etc
•Contagion through physical contact with a sick person e.g. Sexual relationship, inhaling a sick person’s breath, drinking from a sick person’s cup
•Interpersonal conflict, e.g. Wounds provoked by fights and wife beating
•Personal excesses, e.g. prolonged exposure to sun and rain, bathing in cold water, eating unripe crop, drinking immoderately

Question 3

What are illnesses attributed to in the magicoreligious domain

Answer 3

• In this domain of etiology for a disease, illnesses are attributed to God, nature and demonic spirits, ancestral ghosts, magical forces (evil eye, curse) and breach of social taboos or personal vows.
• Violation of religious and social norms is thought to bring about divine retribution in the form of epidemics
• Ailments such as mental illness and epilepsy are routinely attributed to the action of an evil sprit.
• The fear of evil eye and sorcery is wide spread in Ghana.
• This phenomenon is known as “be3yie” among the Akan

Question 4

What exists in the secular healing domain

What type of care is common throughout Ghana

Answer 4

Many ailments are routinely explained with in as empirical framework of illness etiology and treated with curative practices, which do not involve Magico-religious rituals.
•In this domain various levels of specialization exists, ranging from home remedies to professional treatment.

•Self-care by household without the use of professional healers is common throughout Ghana. Several popular remedies for different illnesses exists.

Question 5

Name three self care remedies and the diseases they treat in ghanaian households

Answer 5

For instance, remedies for headache include coffee and lemon tea drinking, and most ethnic groups place leaves in the nostrils to treat colds.
•Rheumatism and arthritis are treated with application of hot and dry leaves on the afflicted part of the body, in some population groups.
•Several skin problems are also treated at home, for example the Sidamo apply a poultice derived from butter and leaves to scabies caused burrows

Question 6

What is complementary alternative medicine

State and define six CAM practices

Answer 6

•Complementary and Alternative Medicine (CAM) is the use of treatments that are not commonly practiced by the medical profession

Faith Healing
•This is the use of suggestions, power and faith in God to achieve healing. Faith healing can be
•Self-treatment through prayer.
•Treatment by a lay person thought to be able to communicate with God.
•Treatment by an official church leader for whom healing is only one of many tasks.
•Healing obtained from a person/ religious leader or group of persons who practice healing fulltime without affiliation with a major religious organization.

•Aromatherapy
Aromatherapy is the use of aromatic oils for relaxation.
•Acupuncture
Acupuncture is an ancient Chinese technique of inserting fine needles into specific points in the body to ease pain and stimulate bodily functions.
•Homeopathy
Homeopathy is the use of micro doses of natural substances to boost immunity.

•Naturopathy
Naturopathy is based on the idea that diseases arise from blockages in a person‘s life force in the body and treatments like acupuncture and homeopathy are needed to restore the energy flow.
•Aryuveda
This is an Indian technique of using oil and massage to treat sleeplessness, hypertension and indigestion.

Question 7

What are the seven categories of traditional healers(GOT The BPM)
What are the functions of general practitioners and oracle men or women

Answer 7

The traditional healers can be categorized as follows:

i. the general practitioners;
ii. Oracle men/women;
iii. Bone setters
iv. Traditional birth attendants;
v. Psychiatrists;
vi. Massagers;
vii. The spiritual healers.

The General Practitioners
•The general practitioners are healers skilled in different aspects in the management of various forms of problems in the community.
•They perform general services and they combine their knowledge of herbal medicine with their skills in divination.
ii. Oracle Men/Women
•These are healers endowed with the special skills of divination. They proffer reasons for the cause of problems

Question 8

What are the functions of bone setters ,traditional birth attendants and psychiatrists
State four surgical practices in traditional medicine (CABE)
And state four other traditional practices

Answer 8

iii. Bone Setters
•These are versed in the art of “fixing” fractured bones with special reference to the hand and leg bones.
iv. Traditional Birth Attendants
•These are mostly women who have special skills in the management and delivery of babies. They specialize in both pre-natal and post-natal services.
v. Psychiatrists
•The traditional psychiatrists skilfully manage mental problems of different types and severities

• Amputation
• Bone setting
• Circumcision
• Eye-brow cutting

Other traditional practices
•Bathing in thermal water
•Placing magical devices (like iron, amulet, etc.)
•Avoiding members from atresians
•Slaughtering of sacrificed animals.

Question 9

State four reasons why a community would use traditional medicine

What is primary health care

Answer 9

Lack of awareness
•Inaccessibility of modern medicine
•Low economy
•Low satisfaction in health personnel

• essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that community and country can afford to maintain at every stage of their bdevelopment in the spirit of self reliance and self–determination
• it forms an integral part of the country’s health system and the over all social and economic development of the country
• it is the first level of contact of individuals the family and the community with the national health system bringing health care as close as possible to where people live and work.

Question 10

What is the history of primsry health care

Answer 10

The New approach of PHC (Alma-Ata, Kazakiston international conference on PHC, 1978)
•It was declared that PHC is the key to the attainment by all people of the world by the year 2000 of a level of health that will permit them to head socially and economically productive life

Question 11

State and explain the philosophies and principles of primary healtch care

Answer 11

Equity and justice
- equitable distribution of services, resources, health care
- if all cannot be served, priority for these in need individual and community
self– reliance
- personal responsibility for their own and their families health
Inter – relationship of health and development
- Development is a multi-dimensional process involving changes in structure, attitude, and institutions as well as the acceleration of economic growth, reduction of in equity and eradication of absolute poverty.
- Better health among adults means a bigger and better work force leads to increased productivity, on the other hand, a developed nations can provide a better health service for its citizens

Principles

I. Equity-.
•Equitable distribution of services, resources and facilities for the entire population.
II Inter-sectoral approach- A joint concern and responsibility of sectors responsible for development in identifying problems, programmes and undertaking actions. Education, income supplementation, clean water, improved housing and sanitation, construction of roads and water ways, enhanced role of women have substantial impacts on health.

III. Community Involvement
- Community involvement is the process by which individuals and families assume responsibility for the community and develop the capacity to contribute to their and the community’s development. While the community must be willing to learn, the health system is responsible for explaining andadvising and providing clear information about the favorable and adverse consequences of the interventions being proposed as well as their relative costs.

Question 12

Name four key health related sectors

Answer 12

• public education and information
• agriculture, commerce, industry
• water, sanitation and housing
• related to human behavior and human development.
• related to human population and economic relationships.
• related to human settlements and environmental control

Question 13

State and explain yhree major determinants of health

Answer 13

A. Public Education and Information
•Teach local health problems in schools
- Use locally produced learning materials
- Organize refresher courses for teachers
- Provide sanitary facilities and water in schools
- Organize a school health (preventive) programme and interschool health competitions.

Informal community education

• Cultural activities, traditional media
• Meetings or community based (mass) organizations
• Guidelines for counselors and health committees
• Adult literacy classes

•Public information for health

• Publicize experiences of community health activities
• Provide accurate information on health status and health problems
• Organize training / orientation seminars for journalists
• Diffuse health related legislation
• Organize periodic awareness campaigns.

Promotion of household food security, local food crop production, fishing and animal husbandry

• Training of farmers in new methods
• Promotion of agricultural extension
• Promotion of agricultural extension
• Organize marketing for agricultural products
• Food hygiene measures
• Local weaning foods
• Management and prevention of specific deficiencies
• Organize conservation/ Storage of foodstuffs
• Production of simple efficient agricultural technologies
• Education/Management of pesticide use.

C. Public works, water, sanitation and housing

Clean drinking water
- Protect and maintain existing supplies
- Provides new water supplies, digging wells, etc.
- Water use and conservation (in the house and education of public)
- Check water quality
• Environmental sanitation
- Drainage of surface rain water
- Ensure adequate disposal of human excreta
- Ensure adequate disposal of domestic waste
- Ensure public education
- Implement, legislative measures

Housing /building

• Promote health protective housing improvements.
• Prepare and promote standard designs of affordable housing
• Demonstrate hygienic measures in hospital/health centers
• Ensure prpecially affordable vector control devices
• Ensure protection from environmental hazards

Question 14

State five components of the elements of primary health care

Answer 14

1. Health education
2. Promotion of food and proper nutrition
3. Adequate supply of safe water and basic sanitation
4. MCH (maternal and child health) including FP(family planning)
5. Immunization
6. Prevention and control of locally endemic disease
7. Rx (medical prescription)of common diseases and injuries
8. Provision of essential drugs

Question 15

What are the teo main approaches of primary health care

Answer 15

A. Comprehensive PHC (CPHC)
- Health is not merely the absence of disease
- Multi-sectoral approaches and community involvement
B. Selective PHC (SPHC) Announced by UNICEF to cut child mortality in the 3rd world.
- Growth monitoring
- ORS
- Breast feeding
- immunization
- Family planning
- Food supplement
- Female education

Question 16

Name six components of prkmary health care

Name five components that were added after the alma-ata declaration

Answer 16

1. Health education
2. Promotion of food and proper nutrition
3. Adequate supply of safe water and basic sanitation
4. MCH including FP
5. Immunization
6. Prevention and control of locally endemic disease
7. Rx of common diseases and injuries
8. Provision of essential drugs

Added:
9. Mental health

10. Oral health
11. Control of ARI(acute respiratory infection)
12. Control of HIV/AIDS and other STIs
13. Occupational health
14. Use of traditional medicine

Question 17

What are the three primary health care strategies

Answer 17

A. Changes in the health care system

• total coverage
• integrated system
• community involvement
• design planning, and management of health system

B. Individual and collective responsibility for health

• decentralization of decision making
• personal responsibility

C. Intersectoral action for health.

Question 18

State two advantages and disadvantages of primary health care

Answer 18

Advantage

• Results achieved faster
• Give more satisfaction

Disadvantage
– limited scope of activities
- disease oriented
- does not address priority problem
- little/no intersectoral collaboration

Question 19

What is traditional medicine

Who is a traditional healer?

Answer 19

TM is “the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health, as well as in the prevention, diagnosis, improvement or treatment of physical and mental illnesses” (WHO, 2000b:1).
• Traditional healer is “a person who is recognised by the community where he or she lives as someone competent to provide health care by using plant, animal and mineral substances and other methods based on social, cultural and religious practices” (WHO, 2000a:11).

Question 20

Hence, TM is broad and diverse. Consequently, different societies have evolved different forms of indigenous healing methods that are captured under the broad concept of TM, e.g. Chinese, Indian and African traditional medicines.
True or false
What are other names for TM?
What’s the oldest form of health care ?

Answer 20

Other names for TM are Ethno-medicine, Folk medicine, Native healing, Complementary and alternative medicine (CAM).
• TM is the oldest form of health care system that has stood the test of time.
• It is an ancient and culture-bound method of healing that humans have used to cope and deal with various diseases that have threatened their existence and survival.
•

Question 21

Prior to the introduction of cosmopolitan medicine ,what was the dominant medical system in Africa?
In Africa the healers are addressed as what in Yorubas? What about among the ibibio? What about among the South Africans? What about the Akans?

Answer 21

Prior to the introduction of cosmopolitan medicine, TM was the dominant medical system available to millions of people in Africa (rural and urban). There are strong indications that traditional health care systems are still in use by the majority of the people not only in Africa but across the world.
•
In Africa, the healers are variously addressed as Babalawo, Adahunse or Oniseegun among the Yorubas, and Abia ibok among the Ibibio communities of Nigeria; Sangoma or Nyanga among South Africans, Odinsini or ninsini/ nyinsini by the Akans in Ghana.

Question 22

Traditional doctors are well known for treating patients how?
What marked a significant turning point in the history of african traditional medicjne?

Answer 22

Traditional doctors (TDs) are well known for treating patient holistically: o Reconnect the social and emotional equilibrium of patients based on community
rules and relationships.
o Also act as an intermediary b/n the visible and invisible worlds; b/n the living and the dead or ancestors, sometimes to determine which spirits are at work and how to bring the sick person back into harmony with the ancestors.
• However, the arrival of the Europeans marked a significant turning point in the history of this age-long tradition and culture.

Question 23

Introduction of western medicine did what?
When did this manifest in South Africa
What is the impact of colonialism on indigenous knowledge system in Africa?

Answer 23

What did colonialism do to our IKS??
• While some critics of colonialism have focused on the economic and political impacts, others have shifted attention to the impact of colonialism on indigenous knowledge system (IKS) especially knowledge of medicine.
• Such arguments underscore the negative impact of colonialism on indigenous medicine.
• It is explained that the introduction of Western medicine and culture gave rise to ‘cultural-ideological clash’ which had hitherto created an unequal power- relation that practically undermined and stigmatised the traditional health care system in Africa because of the over-riding power of the Western medicine.

This became manifested in South Africa during the Apartheid regime

Question 24

What happened in with Africa to hold back the development of African traditional health care?

During several centuries of conquest and invasion what did colonizers introduce? What did this do to pre existing African systems?

The outlawing of traditional medical practices (Native Customs Regulation Ordinance of 1878) therefore negatively impacted the development of TM. True or false

Answer 24

a century of colonialism, cultural imperialism and apartheid in South Africa have held back the development of African traditional health care in general and medicines in particular. During several centuries of conquest and invasion, European systems of medicine were introduced by colonisers. Pre-existing African systems were stigmatised and marginalised. Indigenous knowledge systems were denied the chance to systematise and develop.
• Ghana’s situation is no different: TM was and is still regarded as unevolved, unrefined.

Question 25

In some cases traditional medicine was banned, south african medical association outlawed traditional medical system. When was it outlawed?
When was witchcraft suppressed. What act caused witchcraft suppression amendment
Ban of TM was partially based on what belief?

Answer 25

E.g. The South African Medical Association outlawed traditional medical system in South Africa in 1953 (Hassim, et al. n.d).
• In addition, the Witchcraft Suppression Act of 1957 and the Witchcraft Suppression Amendment Act of 1970 also declared TM unconstitutional thereby disallowing the practitioners from doing their business in South Africa (Hassim et al. n.d.).
• The ban of TM was partially based on the belief that the conception of disease and illness in Africa was historically embedded in “witchcraft” where, in Western knowledge, witchcraft reinforces “backwardness”, “superstition” and “dark continent”.

Question 26

After independence what bodies advanced TM?

Answer 26

TM in Post independence Africa
• Concerted efforts have been made to recognise TM as vital aspect of healthcare delivery system in Africa.
• In Ghana, successive governments have contributed to advancing the development of TM.
o Traditional Medicines Policies and Laws, Act 575, Center for Plant medicine Research, Traditional and Alternative Medicine Directorate (TAMD)
• Formal training of healthcare professionals in TM has been institutionalised to contribute to Ghana’s public health needs
o Medical Herbalists
o Formal training for other CAM professionals

Question 27

TM in primary health care,how do native healers contribute to healthcare needs?

Answer 27

WHO has acknowledged the contributions of traditional healers to the overall health delivery particularly in developing countries (see WHO, 2001; 2002a; 2002c).
• Native healers have contribute to a broad spectrum of healthcare needs that include:
• disease prevention
• disease management
• treatment of non-communicable diseases • Mental health
• gerontological health problems