The “Relevance” of the African Traditional Medicine (Alternative Medicine) to Health Care Delivery System in Nigeria
This paper set out to examine the relevance of the African Traditional Medicine in Health Care Delivery Services in Nigeria. This has become necessary for three main reasons: Firstly, African Traditional Medicine Practitioners provided the earliest medical care in Nigeria. Secondly, the World Health Organisation has recognized the need to integrate the traditional medicine on the orthodox medicine when it defines it, as the total combination of knowledge and practices, whether explicable or not, used in diagnosing, preventing or eliminating physical, mental or social diseases. Thirdly, there are claims by the practitioners that since orthodox medicine cannot cure all diseases; hence, they can intervene in the areas where orthodox medicine is weak. Such areas include, social psychiatry, hypertension, diabetes, epilepsy and other psychosomatic illnesses. The researcher thus took a purposive sample of one hundred and fifty consisting of (50) traditional medicine practitioners, 50 orthodox medicine practitioners and 50 patients using interview and questionnaire administration to garner information on the relevance of traditional medicine in the Health Care Delivery system in Nigeria. Participant observation method was also used to reinforce the interview and questionnaire administration respectively. Secondary data were also obtained from the traditional medical clinics visited in Ibadan, Oyo, lIe-lfe and Ikire all in South Western Nigeria. Data collected were analysed descriptively and the findings are that: (i) African traditional medicine predated orthodox medicine in Nigeria; (ii) Traditional medical care is strong in some areas where the orthodox medicine is not very effective; (iii) There are problems associated with administration of traditional medical care such as issues of measurability of its drugs, dosage, preparation, documentation, preservation, potency and determination of the side effect and (iv) if the shortcomings are rectified, then, the African traditional medicine has a lot to offer in saving lives of African citizens and beyond the continent. The paper concluded that there is a need to properly integrate and blend African medicine on the orthodox medicine because such reinforcement will be of immense advantage to the sick and humanity in general.
CUIDADOS EM SAÚDE: SOCIABILIDADES CUIDADORAS E SUBJETIVIDADES EMANCIPADORAS
Resumo Embora predominem as aplicações técnico/tecnológicas na assistência à saúde como parâmetro e qualificação das ações de cuidado cresce a valorização de uma atenção que abranja mais amplamente a vida dos sujeitos, frente ao reconhecimento que o apoio social e a preocupação afetiva são constitutivos e fundamentais para a efetivação do cuidado. Objetivou-se apreender as reflexões sobre o cuidado à saúde enfocando os aspectos de sociabilidade e de subjetividade. Para tanto, realizou-se uma revisão sistemática de literatura, entre 2003 e 2013, em dez bases de dados. De 262 artigos identificados, foram selecionados 36 que enfocam a subjetividade nas ações de cuidado. Há um questionamento acerca do potencial de cuidado biomédico e suas limitações para atender às múltiplas demandas implícitas nos processos de saúde e doença. Conclui-se que a subjetividade e, em seu interior, a sociabilidade, são partes intrínsecas das ações de cuidado.
Changing access to health services in urban China: implications for equity.
The ongoing reform of public institutions and state-owned enterprises in urban China has had a profound impact on the financing, organization and provision of health services. Access to health care by the urban population has become more inequitable. One of the most pressing concerns is that those who have lost jobs have increasing difficulties accessing health care. Using the data from the national household health surveys conducted in 1993 and 1998, this paper presents empirical results of changing utilization of health care among different income groups. Over 16 000 households and 54 000 individuals in the urban areas were randomly selected to collect information on perceived need of and demand for health care and expenditures on the services. The findings show that the income gap between the highest and lowest income groups increased in real terms from 1993 to 1998. There was a significant decline in the population covered by the government insurance scheme (GIS) and the labour insurance scheme (LIS), while the proportion of the population who had to pay for services out-of-pocket increased from 28% in 1993 to 44% in 1998. There was no statistically significant change in self-reported illness in the 2 weeks prior to survey among the study population over the period. While it was found that more people who reported illness from each income group received medical treatment of some kind, there was a decline in seeking care from a health provider. Among those in the lowest income group who reported illness but did not obtain treatment of any kind, nearly 70% (as compared with 38% in 1993) claimed financial difficulty as the major reason in 1998. The use of in-patient services dropped significantly from 4.5% in 1993 to 3.0% in 1998. The decreased use of in-patient services was more serious in the lowest and lower income groups than in higher and highest income groups. The percentage of patients referred for hospital admission but not being hospitalized had a negative relationship with income level. We can conclude from the data analysis that access of the urban population, particularly the poor, to formal health services has worsened and become more inequitable since the early 1990s. Among possible reasons for this trend are the rapid rise of per capita expenditure on health services and the decline in insurance coverage.