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Background: Traditional healers are in the front line to give the mental healthcare service in developing countries like Ethiopia. In Ethiopia, different studies were done focusing on the role of traditional medicine and perception of the community toward traditional medicine. However, there is paucity of studies, which shows the level of mental health literacy among traditional healers. Therefore, this study intended to mental health literacy level of traditional healers in Jimma town, Ethiopia. Method: A community-based cross-sectional study design was employed among 310 participants. To select the participants from Jimma town, a stratified random sampling method was utilized from August 1 to September 30, 2020. The Mental Health Literacy Questionnaire was used to assess mental health literacy for assessment of mental health literacy among traditional healers. The collected data were coded and entered into EpiData version 4.6 and exported to SPSS version 25.0 for analysis. Bivariate and multivariable linear regression was used for data analysis. Result: The finding of this study showed that the samples of traditional healers found in Jimma town scored a total mean of 95.91 ± 3.0025 for mental health literacy. Age [β = −0.052 (95% CI: −0.078, −0.026)], year of experience [β = 0.095 (95% CI: 0.067, 0.123)], family history of mental illness [β = 1.709 (95% CI: 0.543, 2.360)], history of professional help seeking on mental illness [β = 0.501 (95% CI: 0.715, 2.288)], history of getting information of mental illness on media [β = 0.941 (95% CI: 0.345, 1.538)], training on mental health [β = 2.213 (995% CI: 1.520, 2.906)], history of treating mental illness [β = 1.676 (95% CI: 0.808, 2.544)], and informal education [β = −1.664 (95% CI: −2.081, −1.247)] were factors significantly associated with MHL. Conclusion: The mental health literacy of traditional healers mean score is lower than the mean score of other studies. Age, year of experience, training on mental illness, family history, history of professional help seeking, history of treating mental illness, information on mental illness, and informal education are significantly associated with mental health literacy. Therefore, structured training is very important to improve their level of mental health literacy. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) reports that a significant portion of the global population relies on traditional herbal medicine (THM) due to limited access to safe and high-quality modern medical care. In developing countries, it is difficult to guarantee the safety and quality of THM due to weak enforcement of the legal and regulatory framework. Hence, the study attempted to evaluate the country's legislative and regulatory framework by comparing it with developed and developing countries that have well-established systems and identify gaps for future roadmaps in the THM landscape. Methods: A cross-sectional study and archival review were performed from November 2021 to March 2022 G.C. to contrast the legislative and regulatory framework for THM regulation with other selected countries like Africa, India, and China. A total of 237 regulatory personnel participated in the study. Data were collected through an archive assessment, self-administrative questionnaires, and literature searches. Secondary data were extracted from the archival review, and the findings were summarized and presented in tabular and text formats. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) software version 26, with outputs presented in text, table, and figure form. Results: The archival review of the study found that Ethiopia's THM legislative and regulatory framework is still in a developmental phase, particularly when compared with countries that have more established systems. A cross-sectional study indicated that approximately 79.7% of participants were aware of THM-related content in the current legislation. However, 82.3% reported they had not received any formal training on THM regulations. For future roadmaps, 73.8% of respondents believed the government showed a commitment to supporting THM regulation, though 51.9% of participants noted limited knowledge and awareness of THM practices and product regulations. In terms of quality, safety, efficacy, rational use, and storage conditions, 49.8% of respondents rated regulatory implementation practice as not satisfactory. In this study, most study participants raised concerns about the performance of quality control parameters. Among regulatory experts, weak performance was identified in the practical implementation of THM regulatory activities, with 70.2% of weak performance observed at the federal level and 41.7% at the regional level. Key barriers to effective regulation included a lack of research on herbal medicines (90.3%) and insufficient regulatory mechanisms (87.8%). Additional challenges for regulatory offices included traditional healers' reluctance to engage with scientific communities (56.5%), inadequate inspections (55.3%), and limited data on the safety, quality, and efficacy of certain medicinal plants (54.4%). Conclusion: Overall, the Ethiopian Food and Drug Authority (EFDA) is significantly strengthening the legislative and regulatory framework for traditional herbal medicines (THM), although full implementation is still forthcoming. This study highlights the need for comprehensive policy development, improved training initiatives, and reinforced regulatory systems to effectively monitor and regulate THM practices. For future roadmaps, collaboration among traditional healers, regulatory bodies, and scientific communities, along with supporting evidence-based research, could further enhance THM regulation in Ethiopia. These collaborative endeavors are critical for promoting the safety and quality of products derived from herbal medicines. [ABSTRACT FROM AUTHOR]

Background: Traditional healers play a significant role in Sub-Saharan Africa's healthcare system, but little is known about their role across the cancer care continuum in this context. Given the prevalence of patients consulting healers, we aimed to elucidate their role and impact on cancer care delivery in Sub-Saharan Africa. Methods: Following the PRISMA reporting standards, all research focused on the role of traditional healers in the cancer care continuum in sub-Saharan Africa was included in this scoping review. Data sources assessed include PubMed, Cochrane Library, Embase, and CINAHL Plus with Full Text, Scopus, Sociological Abstracts, African Journals Online, African Index Medicus, and Google Scholar. Studies that lacked perspectives on the healers' role, focused solely on the actual herbal medicines, were written in non-English language, were not primary research, or the full-text was unavailable were excluded. Two reviewers performed screening and data extraction for each article, confirmed by a third reviewer. Results: One thousand four hundred seventy-one studies were identified, with 1437 screened and 191 full-texts reviewed. Of those, 158 were excluded, and 33 (comprising of 1564 healers) were included for final data extraction and analysis. Five studies (64 healers) showed their role in prevention, eleven (454 healers) in diagnosis, twenty-seven (1524 healers) in treatment, and two (25 healers) in palliative care in Sub-Saharan Africa. While some desired increased collaboration with the biomedical system and referred patients, others lacked trust and remained hesitant to provide referrals. Conclusion: Results showed that traditional healers play an important role in cancer treatment. This provides an opportunity to leverage the skills of traditional healers to improve cancer outcomes, in a way that recognizes and respects local culture. Future research focused on improving the collaboration between traditional healers and the biomedical healthcare system may lead to strengthening the referral system and early detection and treatment of cancer. Registration: This study was registered on PROSPERO, CRD42022293055. [ABSTRACT FROM AUTHOR]

A sizeable proportion of child homicides in most African communities is triggered by certain superstitious beliefs and practices such as the so-called "spirit child/children" – children, particularly disabled babies, believed to possess malevolent spirits that cause misfortunes and deaths in their families and the community. Such children are sometimes killed. The present study sought to consolidate and synthesise information on spirit child homicides in African settings to facilitate greater knowledge and understanding of the phenomenon. Utilising the PRISMA guidelines, a literature search for empirical works on spirit child homicides published between 2000 and 2022 was conducted across four databases: Scopus, Web of Science, Journal Storage (JSTOR), and Google Scholar. Thirteen studies met the inclusion criteria. The review shows that spirit child homicide occurs largely in rural communities, and that demonophobia, poverty, poor access to health provision, influence of traditional healers, and lack of support for parents of children with disabilities are the major factors that sustain the practice. Because the spirit child belief is deeply entrenched in the culture of the practicing communities, a multi-layered approach will be required to combat spirit child motivated paedicides. [ABSTRACT FROM AUTHOR]

Background: Traditional childhood uvulectomy (TCU) is an unregulated cultural practice associated with significant health risks, including infections, anemia, aspiration, and oral or pharyngeal injuries. The reuse of unsafe tools such as blades, needles, or thread loops exacerbates the spread of infectious diseases like HIV and hepatitis B. Despite its clinical significance, the pooled prevalence and associated factors of TCU have not been adequately examined through systematic reviews or meta-analyses. Objective: This review and meta-analysis aimed to estimate the pooled prevalence and associated factors of TCU in some African countries. Methods: This systematic review and meta-analysis adhered to the PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including MEDLINE, ScienceDirect, Google Scholar, and African Journals Online, to identify relevant studies. A weighted inverse-variance random-effects model was employed to estimate the pooled prevalence and associated predictors of TCU. Heterogeneity among the included studies was assessed using a forest plot, I2 statistics, and Egger's test, ensuring the robustness and reliability of the findings. Missing data was handled by random effect model and sensitivity analysis. Data extraction was conducted fromNovember 6 to December 23, 2023. Eligibility criteria: Included studies focused on children aged birth to under 15 years, examining TCU defined as the partial or complete removal of the uvula by traditional healers. Participants: Eleven primary studies comprising 7,231 children from some countries in Africa were included. Results: Pooled estimate of TCU in some African countries was 40.98% (95% CI: 25.04–56.92; I2 = 99.61, P = 0.001). Mothers residing in rural areas were 2.45 times more likely to have a child experienced TCU compared to those in urban areas (AOR = 2.45; 95% CI: 1.59–3.32). Similarly, Mothers with a history of having a previous child who undergo TCU were 8.44 times more likely to seek the procedure for their other children compared to mothers without such a history (AOR = 8.44; 95% CI: 6.27–10.61). However, caution is warranted when interpreting these findings due to the significant heterogeneity reported across the included studies, which may influence the generalizability of the results. Conclusions: Nearly two-fifths of children in some African countries experienced TCU, which was influenced by maternal history and rural residency. While most procedures did not result in hospitalization, significant health risks remain. These findings underscore the urgent need for targeted interventions within maternal and child health programs to address TCU and mitigate its associated morbidity in the affected countries across Africa. Prospero I.D.: CRD42024498699. [ABSTRACT FROM AUTHOR]

Background: Informal Healthcare Providers (IHCPs), including Proprietary Patent Medicine Vendors (PPMVs), drug peddlers, traditional healers, and herbal drug sellers are often the first choice for malaria treatment, especially in urban slums. Unplanned urbanization significantly impacts malaria transmission by creating cities with inadequate safety nets and healthcare access, increasing reliance on IHCPs. While the World Health Organization recognizes IHCP's crucial role and emphasizes integrating them into formal healthcare for improved malaria care, they lack requisite training in malaria management and operate outside official regulations, raising concerns about the quality of care they provide. Understanding IHCPs' perceptions and practices is essential for their proper integration. This study explored the perceived malaria burden, IHCPs' competence in malaria treatment, and reasons for visiting IHCPs in various urban settlements from both community member and provider perspectives. Methods: This qualitative cross-sectional study was carried out in Ibadan and Kano metropolises. Eighteen Focus Group Discussions among 157 adult community members and twelve Key-Informant Interviews among PPMVs, drug peddlers, traditional healers and herbal drug sellers were conducted in these cities. Participants were drawn purposively from settlements—designated as formal, informal, and slum based on local definitions—in selected wards within the cities. Data were collected using pre-tested guides and analysed thematically. Results: This study reveals that malaria remains a significant health problem in these Nigerian cities. Patronage of IHCPs generally is driven by affordable treatment, perceived mildness of illness, and access to credit facilities. However, cultural belief was key to patronage of traditional healers and herbal drug sellers, largely among informal and slum residents. Furthermore, while IHCPs had a strong perceived competence in managing malaria cases, inadequate diagnosis and treatment were standard practices. Conclusions: IHCPs remain consistently patronized across urban settlements. IHCPs are continuously patronized in all urban settlement. Educating and equipping IHCPs with diagnostic tools, enhancing access to affordable healthcare, and raising public awareness is crucial for proper malaria management and promoting collaborations with formal healthcare providers. [ABSTRACT FROM AUTHOR]

Lontar usada is a text that contains traditional medicine that the Balinese have trusted for a long time. This knowledge originated in India and then spread to Bali along with the development of Hinduism in the 5th century AD. Lontar usada is written on palm leaves in a long rectangular shape with a size of 3.5 cm x 35 cm. Lontar usada has several types, including lontar usada putih. This study was intended to analyze lontar usada putih as a guideline for traditional medicine using an Ecolinguistic perspective. Qualitative methods were applied in this study. The data source was a document (Translated text of lontar usada putih) with No. 111d 158/2. A number of attachments 38 copied from the lontar belongs to Cokorda Putra from Petak Village, Abianbase District, Gianyar. The researchers also collected data through interviews obtaining data from Kawi (ancient Javanese) particularly. In this case, interviews were conducted to obtain data, especially language rituals or treatment in prayer form, especially Sanskrit. Several informants were interviewed: Pandita (priest) and Balian, a Balinese healer. Based on the results of the analysis, it was found that each treatment in the lontar usada putih not only uses medicinal media in the form of plants but also contains mantras, ceremonies, and special offerings. [ABSTRACT FROM AUTHOR]

Bipolar disorders (BP) are prevalent neuropsychiatric illnesses affecting 1%–5% of the global population and about 3% of the Saudi population. They are associated with significant comorbidities and negative consequences. Despite being common mental health conditions in Saudi Arabia, stigma persists, with weak character, supernatural beliefs, and weak faith considered as causes. In addition, Saudi patients with BP have been reported to seek help from non-psychiatric healthcare professionals and faith healers. More data are required on BP from Saudi Arabia, including the genetic aspects and their treatment approaches. This narrative review paper explores the epidemiology and clinical manifestations, etiology and biological mechanisms, public knowledge and awareness of the illnesses, and treatment of BP in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Background:Objective:Design:Setting:Subjects:Outcome measures:Results:Conclusions:Although infant and young child feeding (IYCF) recommendations are widely accepted in South Africa, inappropriate IYCF practices still exist, leading to malnutrition in children.To investigate the IYCF practices of caregivers in Copesville, Pietermaritzburg (PMB).A cross-sectional study was conducted.Masons Clinic, Copesville, PMB.Two-hundred and fifty caregivers older than 18 years of age caring for a 6–24-month-old child at the time of the study.A face-to-face questionnaire was developed using recent, relevant literature and was validated for the study.The mean age of the caregivers was 32.25 (10.42) years. About 96% (n = 239) of infants were ever breastfed. The mean age at which breastfeeding was stopped was 5.9 ± 4.3 months. Mothers who were still breastfeeding planned to continue breastfeeding for a mean duration of 12.6 ± 5.6 months. About 60% (n = 149) of infants were started on solids at the appropriate age of 6 months. Lennon Entressdruppels (16.9%; n = 14), sugar water (15.7%; n = 13) and fruit and vegetables (13.3%; n = 11) were fed before the age of six months. Forty-nine caregivers (19.6%) consulted a traditional healer regarding IYCF. Non-edible items fed to cleanse the stomach included toothpaste and polish (5.6%; n = 8) and disinfectant solution (1.7%; n = 1).Caregivers should be educated on the benefits of continued breastfeeding until two years or beyond and the importance of starting solids at the appropriate age of six months. The potential dangers to the health of infants of feeding non-edible items should also be highlighted. [ABSTRACT FROM AUTHOR]

The documentation of medicinal plants is an important baseline for possible extraction, isolation, characterization, and chemical modification of important active cellular chemical contents. This study aims to determine the qualitative phytochemical screening of medicinal plants used by traditional healers in Aurora, Zamboanga del Sur, Philippines. A total of 34 medicinal plants were mentioned by five traditional healers, who willingly shared their knowledge on medicinal plants. These plant species were collected and came from 23 families. The greater number of plant species was represented by families of Poaceae, Euphorbiaceae, Lamiaceae, and Asteraceae with three species each, followed by Malvaceae, Compositae, and Leguminosae with two species each, and the rest of the families were represented by only one species each. In this study, qualitative phytochemical analysis of five selected medicinal plants clearly reveals the medically active cellular phytoconstituents such as terpenoids, anthraquinones, phenols, and saponins that were present in Stachytarpheta jamaicensis, Jatropha gossypiifolia, Impatiens balsamina, Phyllanthus urinaria, and Pseudelephantopus spicatus leaves. These medicinal plants appeared to be rich in chemical contents, widely used in traditional medicine to combat and cure various ailments. The anti-inflammatory, antibacterial, antiviral, antimalarial, antiparasitic, antianalgesic and antioxidant can be attributed to the high anthraquinones, phenols, terpenoids and saponins in the leaves of the five medicinal plants. However, the presence of phytoconstituents like terpenoids, anthraquinones, phenols and saponins should take note importantly by the traditional healers or even community in order to have a better understanding on how the plants combat and cure the specific ailments. Furthermore, the study recommends that all medicinal plants should take care of and the future researchers conduct more studies on phytochemical screening of medicinal plants for better understanding on when and how to use different medicinal plants to treat different ailments. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Tridax procumbens has long been used as an insect deterrent, anticoagulant, and for the healing of wounds. In some areas of India, traditional healers also employ T. procumbens to treat injuries, blisters, and boils. A widespread rod-shaped, gram-negative, strictly aerobic bacteria called Pseudomonas aeruginosa can infect both plants and animals, including humans. It can be found in a variety of infections, particularly those that have a tendency to become chronic such as gingivitis and periodontitis. This study aims to assess the minimum inhibitory concentration (MIC) assay of T. procumbens stem extract-based chitosan gel against P. aeruginosa. Materials and Methods: The extract was produced from powdered T. procumbens stem part. To create the wound-healing gel, medium molecular weight chitosan was added to the T. procumbens stem extract to form a homogenous gel. Time-kill assay was conducted to determine the time-kill kinetics of the T. procumbens stem extract-based chitosan gel against P. aeruginosa. Results: The absorbance values decreased progressively over time at all concentrations (25 μL, 50 μL, and 100 μL) showing its inhibitory effect. With the increase in concentration, the inhibitory effect of T. procumbens stem extract-based chitosan gel against P. aeruginosa also increased. Conclusion: T. procumbens stem extract-based chitosan gel has revealed potent antimicrobial activity against P. aeruginosa and therefore the gel can be applied for efficient wound healing. [ABSTRACT FROM AUTHOR]

The refugee experience has been associated with increased rates of psychosocial challenges. At the same time, evidence suggests that those who resettled in Western countries including Canada underutilize the formal mental health services in these countries. The low uptake has been attributed to barriers such as language, complexity of the health systems, and differing explanatory models of illness. The same is true for Somali refugees in the West. Studies suggest that Somali refugees prefer spiritual healing for psychosocial illness and that some return to East Africa for such healing. However, little is known about Somali Canadian's experiences with the Canadian mental health services and transnational health seeking. The study aimed to understand psychosocial challenges faced by Somali Canadians, their health seeking behaviors, and service utilization. Because some sought psychosocial services outside the country, fieldwork was conducted in Kenya to provide new evidence on transnational healing services. Ethnographic fieldwork and in-depth interviews were utilized. Thirty-seven interviews of about an hour each were undertaken. Fieldwork in Nairobi focused on spiritual healing centers and medical clinic. The findings reveal important findings regarding psychosocial challenges experienced by participants. It discusses psychosocial illnesses as variedly experienced, challenges with accessing Canadian healthcare services, and seeking culturally appropriate services in East Africa. The study highlights participants and their families struggle with psychosocial distress, the challenges of accessing culturally appropriate services within Canada, the role of spiritual healers and the existence of transnational health seeking practices. [ABSTRACT FROM AUTHOR]

We investigated the effectiveness of interventions provided by traditional healers for common mental disorders (CMDs) together with associated barriers and facilitators. Electronic databases including MEDLINE, APA Psych Info, Allied and Complementary Medicine, Embase, CINAHL, Social Science Citation Index, and Scopus were searched from inception until October 2021. Randomised controlled trials (RCTs) assessing interventions by traditional healers for CMDs and qualitative and mixed-methods studies examining traditional healers and their attendees' views about the treatment of CMDs by traditional healers were included. Cochrane Risk of Bias Assessment tool (RoB-1) and Critical Appraisal Skills Programme (CASP) were used for the quality assessment of studies. A meta-analysis and thematic synthesis were conducted. Sixteen RCTs (1,132 participants) and 17 qualitative or mixed-methods studies (380 participants) were included. Improvement in symptoms was greater for interventions by traditional healers compared to control groups for both depression and anxiety. Subgroup analyses indicated that only "spiritual passe" interventions showed improvement in depression and anxiety, and participants with co-morbid anxiety and physical conditions showed improvement in anxiety. Facilitators to engaging with interventions by traditional healers were shared faith-based worldview exhibited by traditional healers and their attendees and perceived effectiveness of traditional healing. Stigma and concealing mental illness were found to be barriers not only to formal healthcare but also to traditional healers' services. Interventions by traditional healers such as "spiritual passe" are effective in improving CMDs. However, evidence is still limited due to the low quality of studies and lack of long-term evidence. [ABSTRACT FROM AUTHOR]

The document explores the connections between the Zapatista movement in Chiapas and the Palestinian struggle for liberation, focusing on shared values of resistance, solidarity, and creating new worlds beyond domination. It highlights the importance of understanding and respecting differences while working together against patriarchy and colonialism. The text emphasizes the significance of land, autonomy, and pluralism in both movements, advocating for a world where diverse perspectives and autonomous experiences can coexist. The document features insights from scholar Sylvia Marcos and geographer Linda Quiquivix, who discuss the intersections between the Zapatista and Palestinian struggles and the potential for collaboration in challenging oppressive systems. [Extracted from the article]

The present study focuses on perceptions of forgiveness among formerly incarcerated people engaged in peer-support roles, based on their lived experience and referred to as wounded healers. Participants were 26 men and women with a history of addiction, trauma, and incarceration who are employed in formal peer-support positions and in the community. The participants reported achieving personal and social forgiveness through their peer work, expressing their social acceptance which is relevant to their recovery. The theoretical and practical implications of the findings are discussed from the perspective of convict therapy and Enright's forgiveness therapy. [ABSTRACT FROM AUTHOR]

Amidst continuous calls for decolonization and Africanization in theological reflection on the African continent, this paper looks at the effects of colonialism, its power and the inequalities and vulnerabilities it created, and how, long after the demise of the structures of colonialism, the coloniality1 of the heart and mind still lingers. As a white South African, of French Huguenot descent, I come from the minority group which dominated non-white citizens during apartheid. I still benefit from this past privilege but the opposite is true for those who suffered under apartheid, who lives with a legacy of inferiority. For decolonialization to succeed, the historically wounded should be supported to find their true identity. This article makes use of Exegesis by Story as methodology to describe the journey of the Old Testament judge Gideon, as an example of healing and restoration of the hearts and minds of the oppressed. The research furnishes the church with transformational principles that can be used to come alongside the oppressed, and to facilitating the healing of the wounded to become leaders. [ABSTRACT FROM AUTHOR]

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Background: On September 20, 2022, Uganda declared an Sudan Virus Disease (SVD) outbreak in Mubende District. Another eight districts were infected September–November 2022. We examined how Ugandan community beliefs and practices spread Sudan Ebola Virus (SUDV) in 2022. Methods: A qualitative study was conducted in Mubende, Kassanda, and Kyegegwa districts in February 2023. Nine focus group discussions and six key informant interviews were held. We investigated whether community beliefs and practices contributed to spreading Sudan Ebola Virus (SUDV). Interviews were recorded, translated, transcribed, and thematically analyzed. Results: The community deaths, later found to be due to Sudan Virus Disease(SVD), were often attributed to witchcraft or poisoning. Key informants reported that SVD patients often sought traditional healers or spiritual leaders before or after formal healthcare failed. They also found that traditional healers treated SVD patients without precautions. Religious leaders praying for SVD patients and their symptomatic contacts, SVD patients hiding in friends' homes, and exhuming SVD patients from safe and dignified burials to allow traditional burials were other themes. Conclusion: Diversity in community beliefs and culture likely contributed to spreading the 2022 Ugandan SVD outbreak. Public health systems, traditional healers, and religious leaders can help Uganda control ebolavirus outbreaks by identifying socially acceptable and scientifically supported infection control methods. [ABSTRACT FROM AUTHOR]

Mental illness has been widely debated among researchers and health practitioners, leaving many questions about its nature and the experience of those affected. It generally encompasses health conditions characterized by shifts in thought, emotion, behavior, or a combination thereof, often impairing daily functioning. While mainstream views focus on biological abnormalities as key drivers, non-biological perspectives also provide valuable insights. This review seeks to explore the factors that influence health-seeking behavior among individuals with mental illness, specifically examining why people in India often choose to consult traditional healers. [ABSTRACT FROM AUTHOR]

ABSTRACT Indian nurses coming to the U.S. on H‐1B visas that tie them to employers are often the breadwinner for spouses and other family members on dependant visas, where the dependant spouses do not have the ability to work due to visa regulations, thus upsetting complex gender dynamics in the household. In this paper, we investigate how Indian immigrant nurses in the U.S. navigate their status as the primary migrant and, family breadwinner with the incessant feminizing discourse of immigrant nurses as selfless healers. The paper is based on in‐depth interviews with 30 Indian migrant nurses and their husbands, 10 immigration experts such as lawyers, legislators and activists, 3 years of ethnography in nursing conferences that Indian nurses in the U.S. attended, and in the homes and churches that the nurses and their families attended. Using the construct of “the caring self” our analysis shows that the nurses are continuously subjected to the discourse of nursing work as healing work in formal and informal contexts such as, by recruitment agencies, at nursing conferences, by superiors and peers at work, in their churches and at home. The internalization of the discourse of immigrant nurses as healers often prevent the nurses from processing and verbalizing their gendered and racialized experiences at work, demands of caregiving at home and the community at large. Nursing work as healing work becomes their path toward making of the caring self in the new country. As such, we argue that immigrant nurses operate in a “migrant care work regime” which is bolstered by the intersections of migration policies and a feminized and racialized discourse of migrant nursing work, creating the trope of the constant care worker that shapes the material realities of nurses as immigrant women care workers in the U.S. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa. Methods: We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. Results: The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%–74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43–5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39–4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16–4.49). Conclusion: This meta-analysis's findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy. [ABSTRACT FROM AUTHOR]

Background: Indigenous knowledge healers (IKHs) provide alternative healthcare to formal health services in rural South Africa, but there is a gap in knowledge regarding their treatment of surgical conditions. This study evaluated IKH surgical care and described their perspective of the dual health system. Methods: A cross sectional survey of IKHs in the Madwaleni Hospital catchment of the Eastern Cape, South Africa was conducted. Topics included the training and experience of IKHs, treatment of nine common surgical conditions, referral patterns, disease origin beliefs, benefits and limitations of care, and collaborative opportunities between the two health systems. Results: Thirty‐five IKHs completed the survey. IKHs were consulted by persons with all nine surgical conditions. The most common forms of treatment were application of an ointment on the affected site (88%) and oral medication (82%). Operative treatment was only done for abscess. Referrals to the formal healthcare sector were made for all surgical conditions. IKHs reported that they were limited by their lack of training and resources to perform operations. On the other hand, they perceived the treatment of the spiritual aspect of surgical disease as a benefit of their care. Thirty‐five (100%) IKHs were interested in closer collaboration with the formal health sector. Conclusion: IKHs treat surgical conditions but refer to the formal health sector when diagnostic and operative services are needed. More research is needed to determine the potential advantages and disadvantages between the formal health sector and IKH collaboration. [ABSTRACT FROM AUTHOR]

Despite concerted attempts by colonial governments to stamp out traditional healing practices, the Korekore-speaking Shona people have continued to seek healing for mental illness from traditional healers in present-day Zimbabwe. In this article, I discuss the health-seeking trajectories of Korekore people when confronted with mental illness, particularly when and why they seek out traditional healing, and the role that traditional healers play in the quest for therapy. [ABSTRACT FROM AUTHOR]

Background: Jaundice is a significant health issue in Bangladesh. Many patients choose traditional medicine (TM) over conventional medicine (CM) for treating jaundice. This study aimed to identify and analyze the push and pull factors influencing the preferences of jaundiced patients for traditional healing methods in Bangladesh. Methods: This cross-sectional study used a mixed-methods approach. Two focus group discussions (FGDs) were conducted with 16 participants (8 per group) who had experience of using traditional medicine for jaundice. In-depth interviews with five traditional healers were carried out to gather qualitative insights from the healers' perspectives. Quantitative data were collected from 400 jaundiced patients at a tertiary-level hospital using a semi-structured questionnaire. Chi-square tests and binary logistic regression were used to analyze associations between sociodemographic factors, push-pull factors, and treatment preferences. Results: The study found that 62% of participants favored TM for jaundice treatment. The scalp and hand cleansing rituals (46%), herbal remedies (37%), garlanding (23%), and use of talismans or amulets (21%) were the most common practices. Qualitative analysis revealed five push factors, eight pull factors, four intervening obstacles, and five personal factors that influenced jaundiced patients' preference for TM. Patients also emphasized the significance of spiritual and emotional aspects in their decision-making process when choosing TM. Significant associations were observed between treatment preference and age group (p = 0.002), residence (p = 0.018), education level (p<0.001), and religion (p = 0.015). Individuals aged 50 years and above (70.9%), rural residents (68%), and those with no or primary education (72%) were more likely to opt for TM. Key push factors towards TM included high costs of CM (OR: 6.80, 95% CI: 2.10–22.04) and perceived ineffectiveness of CM. Strong pull factors were accessibility of TM (OR: 11.18, 95% CI: 4.03–31.00), perceived effectiveness of TM (OR: 3.45, 95% CI: 1.05–11.37), personal testimonials (OR: 7.55, 95% CI: 2.75–20.69), lower costs of TM (OR: 10.48, 95% CI: 4.30–25.54) and lack of information about conventional treatments for jaundice (OR: 13.82, 95% CI: 4.62–41.33). Conclusion: The study reveals that both push and pull factors influence jaundiced patients in Bangladesh to choose TM over CM, with decisions shaped by personal, socioeconomic, and geographical factors. [ABSTRACT FROM AUTHOR]

Background: Shamanism is a spiritual tradition in which trance practitioners deliberately modify their state of consciousness to seemingly interact with an invisible world to resolve their community members' problems. This review aims to provide a multidisciplinary overview of scientific research on shamanic trance. Methods: The search was performed using PubMed and Google Scholar databases. Twenty-seven articles were found to be eligible, and their data were classified into four dimensions, namely, a) phenomenology, b) psychology, c) neuro-physiological functions, and d) clinical applications. Results: These studies suggest that these trances are non-pathological, different from normal states of consciousness in terms of phenomenology and neurophysiology, and influenced by multiple personal and environmental variables. Furthermore, while trances may offer therapeutic potential, their scope should be approached cautiously, underscoring the need for rigorous studies to assess the effectiveness of shamanic approaches for complementary therapies. Conclusion: Overall, shamanic trance and its potential benefits remain an intriguing and multifaceted area of scientific study, offering insights into the intersections of consciousness, spirituality, and possibly therapy. [ABSTRACT FROM AUTHOR]

This essay argues that the critical consensus concerning Brian Friel's Faith Healer (1979) as the origin play for an Irish tradition of monologue theatre overlooks the indebtedness of Friel's first monologue drama to Samuel Beckett's Play (1963) and, in so doing, obfuscates Beckett's influence in the evolution of Irish monologic theatre. Tracing the reliance of Play and Faith Healer on musical structures of variation and recurrence, the essay discerns the reach of their interrogation of dramatic storytelling and argues that the subversion of truth-telling in these key plays has exercised a profound influence on the approach to the monologue form in contemporary Irish theatre. The essay examines how Play operates a comprehensive critique of the aesthetic and epistemological traditions upon which western theatre has developed and how through its compulsion to repeat itself reduces theatre to a visceral demand for judgment. The complex forms of duplication in Faith Healer are similarly read in relation to an audience's desire for narrative coherence and, reading the play against its Beckettian precursor, the essay demonstrates how these dramas not only problematise dramatic narrative but, more fundamentally, disrupt an audience's relationship with theatrical presence. The essay concludes with a consideration of Play and Faith Healer as predecessors to the monologic turn in Irish theatre, arguing that the Irish monologue not only speaks back to socio-political narratives but contests theatre's claim to truth-tell. [ABSTRACT FROM AUTHOR]

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Background: The Ghana Health Service aims to ensure the health of all Ghanaians. Understanding the factors that influence people's health-seeking behaviour will help the Ghana Health Service evaluate and enact policies that will enable it to achieve set targets. This research aimed to determine the factors that influence the health-seeking behaviour of the residents of Jasikan District and ascertain the importance of the well-being clinic in this context. Methods: The study design was a community-based cross-sectional study using a mixed method of data collection. A stratified sample of 295 respondents from the five [5] sub-districts of the target population was obtained. Cramer's V statistic was used to assess the effect size and significance of the association between categorical variables. Further, multiple binary logistic regression was used to determine significant predictors of health-seeking behaviour. Health seeking behaviour was categorised as appropriate or inappropriate. The health seeking behaviour of participants was considered appropriate if they sought health care at public health facilities, private health facilities, and licensed Pharmacies/OTCMS and inappropriate when participants sough care at traditional/faith healers, engaging in self-medication, and not taking action during an illness episode. Results: The mean age of participants in the study was 37.49 ± 15.74 years. Females comprised the majority of study respondents (160; 56.3%). When they fell ill, 61% of respondents chose formal public health institutions as the first port of call. A significant proportion of respondents (245; 83%) preferred appropriate health-seeking behaviour, with age (p = 0.045) and health insurance status (p < 0.01) significantly influencing where respondents sought care. More than half of respondents indicated that affordable service (59.9%), readily available drugs (54.5%), and good services (52.0%) are key characteristics of respondents' preference for service in healthcare. The educational level significantly correlated with service characteristics when people seek health care (p = 0.035). The severity of illness (9; 28.1%), perception of a facility as the best place (7; 21.9%), well-trained staff (4; 12.5%), and professionalism (3; 9.4%) influenced respondents' choice of health care. More than half (78%) of respondents agreed with the need for a well-being clinic in a hospital. The binary logistic regression indicates that religion is a significant predictor the appropriateness of participants' health seeking behaviour, but the overall model could not improve the overall prediction rate of the constant model. Conclusion: The health-seeking behaviour of the people of Jasikan is good. The participants' sex, good service, affordability, and availability of medicines are critical service characteristics that influence the choice of healthcare providers. Managers of health facilities should consider these characteristics to remain competitive and drive positive health-seeking behaviour in the community. Facilities are encouraged to set up a functional well-being clinic and open it to the public. [ABSTRACT FROM AUTHOR]

Background: Tungiasis, an ectoparasitic disease caused by sand fleas, causes suffering to millions of people in the tropics. Although the Kenyan National Policy Guidelines list tungiasis treatments as including disinfectants, flea repellents, and botanical oil, the insufficient knowledge and financial constraints of affected communities have led to neglect and inappropriate self-treatment. Current reports show insignificant progress on educational activities at the community level. Therefore, we investigated community residents' treatment-seeking behaviour concerning tungiasis, using an endemic area of Kenya as the research setting. Methods: A cross-sectional mixed-methods design was employed. Quantitative data were collected from the participants—410 adults who had experienced tungiasis—using a questionnaire, while qualitative data were collected from 20 older adults to 10 medical staffs using semi-structured individual interviews. The study was conducted in two sub-counties of Homa Bay County, Kenya. Results: Factors significantly correlated with using non-guideline-listed treatments for tungiasis were 'not knowing the causse of tungiasis', 'not seeking treatment from healthcare facilities and traditional healers', and 'wait and see to prevent infection in non-affected members'. The interviews with the older adults revealed 19 self-treatment options for tungiasis, and 40% of the participants opted for self-removal using sharp objects. Only two of these treatments were listed in the guidelines. The most frequently mentioned reason for using a self-treatment option was 'Someone else's idea'. The most frequently mentioned reason for choosing the best self-treatment option was 'Effectiveness'. Interviews with medical staff revealed 11 treatment options; only five of these treatments are listed in the guidelines. The most frequently mentioned reason for selecting/using the treatment was 'Supply situation'. Conclusions: Residents' socioeconomic factors, cultural factors, and access to appropriate treatment, as well as knowledge of medical staff were significant factors that influenced the residents' tungiasis treatment-seeking behaviours. This study provides feasibility and baseline data to establish an effective, safe, and sustainable treatment for tungiasis. [ABSTRACT FROM AUTHOR]

Introduction: Medicinal plants are commonly employed mainly due their accessibility, affordability and potency. However, medicinal plants and the associated knowledge are disappearing at an alarming rate due to natural and anthropogenic causes and thus a need for their proper documentation conservation. This study was performed to document traditional knowledge related to use of medicinal plants in Heban-Arsi district, West-Arsi Zone, Oromia Regional State, Ethiopia. Methods: Interviews were conducted with 185 informants to identify medicinal plants used in traditional therapies in the study area. Informant consensus factor (ICF), rank order priority (ROP) values were computed, and preference ranking exercises were performed to assess the relative importance of medicinal plants. Descriptive and inferential statistics were used to measure and compare medicinal plants knowledge between social groups. Results: A total of 120 medicinal plants were identified for being used to treat different human and animal illnesses in the study area. Most of the medicinal plants (76.4%) were uncultivated ones obtained from different habitats. Leaf was the most frequently used plant part constituting 62.6% of preparations. Oral was the most commonly used route of remedy administration (46%) in treating diseases. Gastrointestinal ailments category had the highest ICF value (0.83). In the study area, the highest rank order priority (ROP) values were recorded for Dombeya torrida (J.F. Gmel.), Artemisia absinthium L., Balanites aegyptiaca (L.) Del., Combretum pisoniiflorum Klotzsch) Engl., Celtis africana Burm. f, Ocimum gratissimum L. and Lagenaria sp. for their uses against snake poison, tuberculosis, liver disorder, stomachache, tuberculosis, febrile illness and liver disorder, respectively, each scoring a value of 100. Significant differences in medicinal plant use knowledge were recorded between male and female informants of different educational level, age and experience. Anthropogenic factors were the primary threats to medicinal plants in the area. Conclusion: The study area was found to be rich in medicinal plants that are useful in treating a wide range of human and animal illnesses. In future pharmacological and phytochemical investigations, priority needs to be given to medicinal plants of the highest ROP values and those that were reported against ailment categories scoring the highest ICF values. [ABSTRACT FROM AUTHOR]

The study aimed at exploring and validating the nematicidal potentials of Pleurolobus gangeticus and Tragia involucrata against the gastrointestinal parasitic nematode of cattle called Haemonchus contortus. Both plants are well known for their ethno-pharmacological properties and have been used by various traditional healers. Plant parts were extracted using ethyl acetate, ethanol and water in an accelerated solvent extractor and the crude extracts were evaluated for its nematicidal potentials against eggs and L3 larvae of H. contortus using egg hatch inhibition assay and larval paralysis assays respectively. The effects of the potent extracts on mitotic machinery was evaluated in vitro by performing an Allium cepa assay. Molecular docking analysis was also performed to evaluate the binding affinity of phytoconstituents to tubulin protein. The ethanol extracts of both P. gangeticus (DME) and T. involucrata (TME) showed the strongest inhibition of 90.83±0.98% and 90.5±1.64% respectively on hatching of eggs at 10 mg/mL concentration. At this concentration, larval paralysis assay also showed 65.5±2.25% mortality for DME and 64.5±0.54% mortality for TME treated nematodes. Ethyl acetate extracts of both plants showed relatively less inhibition on egg hatch and larval paralysis and the aqueous extracts were the least potent among the three. The Allium cepa assay revealed an accumulation of cells in the metaphase when treated with colchicine (32.3%) or extracts (DME-36.1%; TME-35.5%) as compared to the vehicle controls (22.9%). In silico analysis revealed that several components in DME and TME has strong binding affinity with the colchicine binding site (CBS) of tubulin protein complementing its observed anthelmintic potential. [ABSTRACT FROM AUTHOR]

The Chechen authorities' focus upon population health is enacted both through the principles of Islamic medicine and approved biomedical practices. Any healing practices beyond these domains are met with deep suspicion. Practitioners of unofficial complementary and alternative medicine healers may abruptly find themselves regarded as enemies of the state. In light of this precarious circumstance, it becomes pertinent to inquire: How do these healers employ their daily tactics to negotiate the intricate power dynamics between the formidable state apparatus and the established biomedical order? Drawing from our meticulous fieldwork conducted in the year 2021, we investigated the intricate tactics employed by unofficial healers in the Chechen medical landscape during COVID-19. Our research centred on discerning the nuanced tactics aimed at mitigating potential risks. We conclude that healers, having embodied tactics to creatively manoeuvre within the confines of the authoritarian state, perceived the challenges posed by COVID-19 as merely another, often inconsequential, obstacle in their enduring struggle. [ABSTRACT FROM AUTHOR]

For tribal people to preserve their historical legacy and advance environmentally friendly healthcare habits, traditional medicinal knowledge must be preserved. This is especially true for the Bonda tribe in the Malkangiriarea of Odisha. The Bonda tribe, who live in the Eastern Ghats, mostly depend on narrative Indigenous Medicinal Knowledge (IMK) shared among elders and traditional healers (Desaris). This study investigated the processes of knowledge transmission, the social networks that sustained the IMK system, and the preservation and ways adopted in Bonda Community. Data were gathered from multiple Bonda villages using purposive sampling technique during 2023-24 years. Qualitative methods and participatory research were used for data collection, and chord diagrams were used for visualization. The results showed a strong IMK network with important contributions from Desaris and strong community linkages. The preservation of sanctified groves and therapeutic herbs through conservation techniques, incorporating new information and preserving transmission secrecy were examples of adaptation tactics. This investigation promoted approaches that encouraged safeguarding Indigenous Medicinal Knowledge (IMK) by highlighting the significance of Indigenous Knowledge Network (IKN) in maintaining traditional identities and social well-being. [ABSTRACT FROM AUTHOR]

INTRODUCTION: In 2018, the World Health Organization recognized traditional healers as community stakeholders in dementia care. This scoping review aimed to summarize the existing dementia care literature regarding strategies for the integration of traditional healing in dementia care and the roles of traditional healers. METHODS: A group of Indigenous Elders from Northern Ontario, Canada, guided, reviewed, and validated the research process and findings. The Joanna Briggs Institute approach was applied to a structured search strategy across the CINAHL, Embase, MEDLINE, and PsycINFO databases. A title and abstract screening were completed, followed by a full‐text assessment of the identified manuscripts. RESULTS: A total of 143 full manuscripts were reviewed, of which two studies fully met the community‐determined inclusion/exclusion criteria. DISCUSSION: The integration of traditional healing practices into dementia care offers a pathway to culturally‐safe care for people with dementia. The findings identified policy advocacy as key to engage, educate, and empower traditional healers. Highlights: The WHO recognized traditional healers as community stakeholders in dementia care and prevention worldwide in 2018; however, traditional healers are underrepresented and marginalized in healthcare systems due to the lack of culturally‐safe dementia care (CSDC) policies at community and national levels globally.Community‐based CSDC models were critically reviewed and validated by local Indigenous community stakeholder consultations.The result is a call to action to assist the WHO and Alzheimer's Disease International in developing guidelines for CSDC policy improvements with the global Indigenous community for the engagement and empowerment of traditional healers to navigate dementia care and to implement the WHO Global Action Plan on the Public Health Response to Dementia (2017–2025).Integration of Western biomedical and Indigenous traditional healing and medicine in dementia care in the healthcare system can reduce health disparities and empower traditional healers on a global scale. Indigenous‐led models that include traditional healers in dementia care are critical for improving equity gaps in dementia care for Indigenous Peoples. [ABSTRACT FROM AUTHOR]

The study of indigenous knowledge in India has evolved over the years and gained significant importance as a vital area of research. This study aimed to explore the evolution of the research landscape on indigenous knowledge in India over the last twenty years (2003-2022), focusing on growth trends and knowledge mapping through Scientometric tools. The study collected 1,980 data from the Scopus database, indexed between 2003 and 2022. Initially, the analysis focused on measuring the research growth and performance of the key players. Then, the study performed scientific knowledge mapping, visualizing the relationships between different concepts and topics within the field. The findings reveal a significant growth in indigenous knowledge research in India. The study also identified key research themes, including traditional medicine, agriculture, biodiversity conservation, etc. In the early two decades, research was conducted on natural resource management, ethnoveterinary practices, ethnomedicine, biodiversity, tribal communities, and traditional healers, etc. The most recent research topics were COVID-19, sustainability, livelihood, ethnopharmacology, climate change, herbal drugs, etc. Research on medicinal plants and ethnobotany was the most influential in the last two decades. Furthermore, the study revealed a highly interconnected network of authors and institutions, with a few key players dominating the field. The study concludes by highlighting the need for further research on indigenous knowledge in India, particularly in areas such as intellectual property rights, geographical identification, preservation, and the role of indigenous knowledge in sustainable development. [ABSTRACT FROM AUTHOR]

The study aimed to document ethnomedicinal plants utilized by indigenous populations across various tribal regions of Himachal Pradesh. Data were gathered from 400 local inhabitants, including traditional healers and vaids from tribal areas. The survey spanned 80 villages between 2021 to 2023. A total of 119 plant species, encompassing 106 genera and 64 families, were identified for their medicinal properties. Of these species, 66% were herbs, 23% trees, 5% shrubs, 4% climbers, with 1% species each of fungus and lichen. The families Asteraceae and Ranunculaceae were found to contribute the highest number of medicinal species. Roots were the most frequently used plant part, followed by leaves. The study revealed that approximately 49% of the population lacks ethnomedicinal knowledge, indicating a decline in traditional knowledge due to the rise of allopathic medicine. Furthermore, a significant reduction in indigenous knowledge was observed among younger and middle-aged individuals compared to those over 70 years old. This trend underscores the necessity of conserving ethnomedicinal knowledge for future generations. [ABSTRACT FROM AUTHOR]

This article describes the health-care access experiences of Indigenous members of a Gulf Coast, non-federally recognized tribe. Research exploring the experiences of non-federally recognized tribes is needed, as these tribes lack resources available to federally recognized tribes. Using a qualitative description research approach and through partnership with a community advisory board, thirty-one semi-structured life-course interviews were conducted with women tribal members. A qualitative descriptive analytic approach revealed the following key themes: First Health-Care Experiences; Going to Family Members for Health Care; Going to Indigenous Healers for Health Care and; Generational Changes in the Transmission of Traditional Knowledge. Our findings highlight the role that family members and Indigenous healers play in addressing health-care gaps and needs for tribal members. In addition, results suggest that Indigenous healers are respected, valued members of the community, and there is concern that healing knowledge is not being passed down to future generations. This research addresses a gap in the need for holistic understandings of Indigenous women’s reproductive and sexual health care, which is required for the development of interventions which not only address social justice issues and weaknesses in the health-care system, but that also promote the existing strengths and resources in Indigenous communities.

In this article, I present the individual ethnography of Amina, a Senegalese woman possessed by the spirits of her lineage. Amina's story shows the lacerations of a person who simultaneously inhabits two worlds: the traditional Lebou culture and the Western one. When her spirits manifest themselves, she is forced to choose between two different interpretations of her suffering: the traditional persecutory and the Western psychopathological. She chooses the former but refuses the healers imposed by the tradition and turns to a priest of her choice, who proves to be sensitive to her need to personally own the healing journey. Amina strategically manipulates the plasticity of the traditional belief system without abandoning it; she bends it to shake the boundaries of herself, and her group and lineage. She uses the disruptive potential of possession and the irruption of the invisible world in the visible to renegotiate her role and acquire a new status in her group. She uses the performative dispositive of possession to renegotiate and expand her spaces of agency and affirm her tenacious subjectivity of a permanently liminal person, one who inhabits, shakes and redraws the boundaries between different worlds of meaning. [ABSTRACT FROM AUTHOR]

Community support is known to play an essential role in enhancing maternal health during pregnancy. This is primarily due to the influence of societal factors on the health status of both the mother and fetus. In addition, the significance of community support is particularly evident in the Gorontalo community of Indonesia due to the influence of socio-cultural factors. This study aims to analyze the extent of culture-based Gorontalo community support for short-term pregnant women in improving maternal health and preventing stunting neonates. The procedures were carried out using a qualitative study method with a phenomenological approach. The sample population comprised 12 pregnant women, 9 village midwives, and 6 cadres, who were selected using the snowball sampling method. In addition, data collection was carried out through in-depth interviews and observations, followed by analysis using Interpretive Phenomenology Analysis (IFA). The people of Gorontalo were very supportive and concerned about the health of short-term pregnant women and fetuses to prevent stunting neonates. A form of culture-based community support comprised regular reminders to pregnant women to diligently attend monthly check-ups with both traditional healers and healthcare professionals. Traditional healers, also known as shamans, fulfilled their role by performing a range of rituals believed to enhance health and well-being. These rituals typically included massages, administering water fortified with sacred chants, and conducting monthly ceremonies for 7 months. In addition, community members frequently offered food preferences to pregnant women and provided reminders to avoid taboos. In summary, community support deeply rooted in culture can serve as a powerful reminder for expectant mothers to undergo regular check-ups with both traditional healers and healthcare professionals on a monthly basis. [ABSTRACT FROM AUTHOR]

Background Podoconiosis is a progressive and debilitating form of tropical lymphoedema endemic to Rwanda. Although the physical and psychological consequences are well known, few studies have evaluated the financial burden of podoconiosis. Methods This cross-sectional, quantitative study aimed to characterize direct treatment costs and impacts on annual earnings among individuals living with podoconiosis. Participants from two highly endemic districts were invited to complete a survey focused on health-seeking history, insurance status, out-of-pocket costs and income changes. Direct treatment costs included medical expenditures (consultation, diagnostics, medication) and non-medical expenditures (food, transportation, accommodation). Results Overall, 226 adults (≥18 y of age) diagnosed with podoconiosis participated. Most had access to community-based health insurance (91.6%) but were unable to work (71.7%). Respondents sought care from health centres/posts (61.9%), hospitals (25.1%), traditional healers (5.8%) and/or community health workers (4.0%). On average, study participants paid US$32.50 (range US$0–779.23) annually, or 11.7% of their household salary, on podoconiosis treatments. Conclusions This study demonstrates the significant financial burden of podoconiosis on individuals and their communities. Increased attention on integrating podoconiosis management into primary care systems and testing cost-effective solutions is needed to protect those who are most vulnerable. [ABSTRACT FROM AUTHOR]

Background: Snakebite envenoming (SBE) is a potentially life-threatening event that can lead to severe physical, mental, and economic hardships, particularly in under-resourced regions like sub-Saharan Africa. In Rwanda, there have been no epidemiological assessments of SBE to guide the Ministry of Health in its efforts to reduce the burden. This study had two main objectives: first, to estimate the incidence of snakebites across districts, and second, to describe formal versus informal healthcare seeking behaviors among snakebite victims in Eastern Province, Rwanda in 2020. Methodology: This cross-sectional study utilized a cluster sampling approach, involving Community Health Workers (CHWs) who recorded snakebite cases across seven districts. The descriptive analysis considered sampling weights, and healthcare seeking behavior was assessed based on the type of care sought as the first point of treatment. Findings: The study surveyed 390,546 individuals across 763 villages and estimated a provincial annual incidence rate of 4.3 cases per 1,000 individuals. Incidence estimates ranged from 1.1 cases per 1,000 in Nyagatare to 9.1 cases per 1,000 individuals in Bugesera and Ngoma districts. Among the 2,545 cases recorded by CHWs, three resulted in deaths. Regarding healthcare-seeking behavior, 13% of snakebite victims (143 out of 1,098) initially consulted formal care providers (CHWs, health post/center, or hospital), while 87% sought informal care (family/friends, pharmacist, or traditional healer). Approximately half of the victims (583, 53.1%) reported severe symptoms. Unsafe practices included skin cutting/burning, tourniquet application, use of black stones, and venom extraction; only 24 cases (2.2%) received anti-venom. Conclusions: This large-scale community-based assessment highlights variations in snakebite incidence between districts and confirms frequent involvement of traditional healers in management. Improving access to anti-venom and community education on the risks of ineffective practices, along with timely use of formal healthcare, are crucial. Collaboration between healthcare providers, traditional healers, community leaders, and policymakers is essential to implement targeted interventions for enhancing snakebite prevention and management strategies. Author summary: Snakebites can be life-threatening, especially in places like sub-Saharan Africa. In Rwanda, there haven't been any studies to understand how many snakebites happen and where they happen. This study wanted to find out two main things: first, how many snakebites happened in different parts of the Eastern Province of Rwanda in 2020, and second, where people who got bitten by snakes went for help—to doctors or traditional healers. The study involved 390,546 people across 763 villages. It found that each year, about 4.3 out of 1,000 people in the province get bitten by snakes, but the numbers vary in different areas. Surprisingly, only 13% of the victims initially consulted formal healthcare providers like community health workers, health centers, or hospitals. In contrast, a larger group, 87%, sought informal care from family, friends, pharmacists, or traditional healers first. About half of the people bitten by snakes experienced severe symptoms. Unfortunately, many people used unsafe methods to treat snakebites, like cutting or burning the skin, tying a tight band around the bitten area, using black stones, or trying to suck out the venom. Only a very small number of cases, just 24 out of all 1,098 victims, received anti-venom. The study suggests we need to make sure anti-venom is easier to get and teach communities about the risks of unsafe practices and why it's important to get formal healthcare quickly. It's important for doctors, traditional healers, community leaders, and government officials to work together to make sure people get safe and appropriate treatment and learn how to prevent snakebites. [ABSTRACT FROM AUTHOR]

Background & objectives India accounts for about seven per cent of the global cancer burden with the highest cancer incidence reported from the North-Eastern Region (NER), including Meghalaya. Despite this, there is paucity of published studies on health seeking behaviour for cancer in the NER. To address this gap, this study used a qualitative approach to document patient, caregiver and provider perspectives to understand the factors influencing healthcare seeking for cancers in Meghalaya. Methods In-depth interviews were undertaken with 37 individuals diagnosed with one of the top five cancers in Meghalaya, namely, oesophageal, breast, oral, cervical and lung cancer. They were identified from the State referral cancer hospital. Twelve caregivers and five healthcare providers were also interviewed. All interviews were conducted in the local language using semi-structured interview guides. Transcripts were translated to English, coded, categorized and analyzed using thematic framework content analysis approach. Results A key factor influencing delayed cancer treatment in Meghalaya included misconceptions regarding the causes of cancer and cultural concepts such as bih and skai (Khasi language), i.e. notions of a figurative 'poison' or ill intent that makes one susceptible to illness. A general reluctance to discuss cancer diagnoses, perceived stigma, apprehension of treatment methods influenced their decision. Other factors included negligence and misinterpretation of early symptoms of cancer, self-management, preference for traditional medicines, financial constraints and health system-related factors. Interpretation & conclusions This study underscores the importance of addressing barriers to cancer diagnosis and treatment in indigenous populations in northeast India, advocating for culturally appropriate messaging, capacity building for healthcare workers, integration of traditional healers, and community involvement to enhance early healthcare seeking and improve outcomes. [ABSTRACT FROM AUTHOR]

We examined the entanglement of biodiversity conservation, human–animal interactions, zootherapy, and local beliefs among Sumatran Healers and their local community by completing an ethnography of 43 Indigenous Healers across 8 tribes in Bengkulu Province, Sumatra, Indonesia. Data collection tools were interviews, observations, videos, photographs, and a researcher journal. Of the 43 Healers, 30 used animals and mentioned 62 species. Of the animals identified, the International Union for Conservation of Nature Red List lists 34% (n = 21) as endangered, decreasing, or vulnerable, including Sumatran tiger (Panthera tigris sumatrae), Sumatran elephant (Elephas maximus sumatranus), and Sumatran rhinoceros (Dicerorhinus sumatrensis). Of the 30 Healers using animals, 50% (n = 15) practiced healing with at least one endangered, decreasing, or vulnerable animal. We defined 3 personas: Healer self‐persona, Healer‐imposed persona, and community‐imposed persona. A persona represented a group's opinions and sentiments related to Healers killing animals for medicinal purposes. Using an iterative data analysis process, we grouped the data across the 3 personas into 5 themes: ease of killing and preparing animals, emotions related to killing animals, animal value, relationship to religion, and Healers are tricksters. The complexity of merging the identities of Healers and the community within an actor‐network embodies the relationality of actions, interactions, and feelings among Healers, between Healers and animals, and between Healers and the community. Conservationists should be cognizant of Healers' medicinal use of animals, views of human–animal interactions, and zootherapy from all social and emotional perspectives. The data led to defining Indigenous Healer ecological knowledge components of zootherapy, human–animal interactions, and biodiversity conservation. [ABSTRACT FROM AUTHOR]

In the control of infectious diseases worldwide, awareness of the population occupies a prominent place. In Africa, there has been a long standing rivalry between traditional medicine and modern medicine. Any disease control strategy must take into account disease-oriented education, as this has a direct influence on the choice of treatment type to follow. In this work, we present a mathematical model that takes into consideration not only public health awareness but also the significant contribution of traditional medicine to the Ebola treatment effort. This study uses data from the 2014–2016 Ebola outbreaks in Sierra Leone and Liberia. Theoretically, we show that our model exhibits a trans-critical bifurcation at |$\mathcal{R}_{c}=1$| and a backward bifurcation phenomenon whenever |$\mathcal{R}_{c}^{c}<\mathcal{R}_{c}< 1$|⁠. While the disease persists when |$\mathcal{R}_{c}>1$|⁠. In addition, a threshold number |$\mathcal{T}_{0}$| is obtained, which ensures the global asymptotic stability of the disease-free equilibrium when its value is less than 1. Numerically, it is shown that the number of hospitalized infected cases increases more rapidly than the number of infected cases treated by traditional healers in both countries, suggesting that people have a high tendency to visit hospitals than visiting traditional healers. Our analysis reveals that during an Ebola outbreak, awareness messages should target the susceptible population for behaviour change in order to mitigate the spread of the disease. Calibrating the model, it fits well the weekly cumulative cases in Sierra Leone and Liberia, and their corresponding estimated control reproduction numbers are |$0.5725$| and |$0.8340$|⁠ , respectively. [ABSTRACT FROM AUTHOR]

Introduction: Plants have formed the basis of traditional medicine (TM) systems, which have been used for thousands of years. According to reports, one-quarter of the commonly used medicines contain compounds isolated from plants. This study aims to identify and document the plants for ethno-pharmacological use by the indigenous communities of West Shoa Zone, Oromia region, Ethiopia. Methods: The cross-sectional study was conducted from November 2020 to November 2021 in West Shewa Zone, Oromia Region, Ethiopia. The ethnobotanical data was collected from Ejere District, Ada Berga District, Dandi District, Ambo District, Ambo Town, Toke Kutaye District, and Bako Tibe District. A descriptive statistical method (percentage and/or frequency) was employed to summarize ethnobotanical data. Moreover, the informant consensus factor was computed. Microsoft Excel spreadsheet software (Microsoft Corporation, 2016) and SPSS (version 25) were used to organize and analyze the data. Result: In the study area, a total of 51 families of medicinal plants with 108 Species were identified. Fabaceae 8 species, Asteraceae, Solanaceae and Lamiaceae each with 6 species and Cucurubitacieae 5 species were the frequently reported medicinal plants. The leaf (57.2%) was the most widely used medicinal plant parts, and oral administration (56.5%) was the most cited route of administration. In the present study, most of the medicinal plants were used fresh, which was (75%) and the most common disease the healers treated was gastrointestinal disease, followed by skin disease and febrile illness. The major threat tomedicinal plants in the study area was agricultural expansion, which was reported by 30.6% of the respondents. The study area was rich in medicinal plants, Fabaceae which commonly used family. Conclusion: Most of the medication prepared by the traditional healers was taken orally and derived from the leaf part of the medicinal plant. Since this research is a preliminary study which will be used as a base for further study. The efficacy and safety of the medicinal plant claim should be studied in the future. [ABSTRACT FROM AUTHOR]

This paper aimed to reflect on the educational process about the traditional knowledge regarding the act of blessing nowadays. To do so, different forms of rescue, acquisition, and transmission of traditional knowledge are presented, along with eco-pedagogical processes of care in the blessing practice, which are articulated with literature on the ecology of knowledge, care ethics, and the Living Well philosophy. This paper results from bibliographic review, participatory research, and semi-structured interviews with two female healers from the Escola de Almas Benzedeiras of Brasília (Federal District, Brazil). Thus, possible convergences were identified between theoretical perspectives and practices present in the narratives of these women to understand how this knowledge was constituted in their lives and culminated in environmental education practices in eco-pedagogical bases favorable for the social, cultural, and environmental sustainability of the Cerrado biome. [ABSTRACT FROM AUTHOR]