Medical Pluralism By Yusuf Abdu Misau

11,838 views
11,598 views

Published on

describes forms of medical care alternatives existing in any giving society

Published in: Health & Medicine
1 Comment
0 Likes
Statistics
Notes
  • Be the first to like this

No Downloads
Views
Total views
11,838
On SlideShare
0
From Embeds
0
Number of Embeds
22
Actions
Shares
0
Downloads
156
Comments
1
Likes
0
Embeds 0
No embeds

No notes for slide

Medical Pluralism By Yusuf Abdu Misau

  1. 1. Medical pluralism Dr. Yusuf Abdu Misau MBBS(ABU), MPH(UM), PhD Student(UM) Department of Social and Preventive Medicine, University of Malaya
  2. 2. Acknowledgement <ul><li>I wish to acknowledge A/P Nabilla Al-Sadat for permission to use her slides in this presentation </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  3. 3. Case Study <ul><li>Mr A is a 32 year old man in your community who has been complaining of headaches for the last one month. </li></ul><ul><li>Discuss his process of seeking help for his problem </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  4. 4. What is Medical pluralism? <ul><li>“ Prior to the emergence of biomedicine as the dominant system of healing, endowed with monopolistic powers by favor of most western states, many other forms of healings had flourished”. </li></ul><ul><li>Porter 1989 </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  5. 5. What is Medical pluralism? <ul><li>Medical pluralism is the adoption of more than one medical system, or the simultaneous integration of both orthodox medicine with complementary and alternative medicine (CAM) </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  6. 6. Components of a Health Care/ Medical system <ul><li>A medical system has two inter related aspects: </li></ul><ul><ul><li>A cultural aspect- includes certain basic concepts, theories, normative practices and shared modes of perception </li></ul></ul>01/19/10 Medical pluralism_Yusuf Misau
  7. 7. <ul><ul><li>A social aspect- including its organization into certain specified roles and rules governing relationships between these roles in specialized settings (such as a hospital or a doctor’s office) </li></ul></ul>Components of a Health Care/ Medical system 01/19/10 Medical pluralism_Yusuf Misau
  8. 8. The three sectors of health care <ul><li>Kleinman: Three overlapping sectors of health care </li></ul><ul><ul><li>The popular sector </li></ul></ul><ul><ul><li>The folk sector </li></ul></ul><ul><ul><li>The professional sector </li></ul></ul><ul><li>Its own ways of explaining and treating ill health </li></ul><ul><li>Defining who is the healer and who is the patient </li></ul><ul><li>Specifying how healer and patient should interact </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  9. 9. 01/19/10 Medical pluralism_Yusuf Misau POPULAR SECTOR
  10. 10. The popular sector <ul><li>The lay, non-professional, non-specialist domain </li></ul><ul><li>Ill health is first recognized and defined here </li></ul><ul><li>Health care activities are initiated </li></ul><ul><li>All therapeutic options that people utilize without any payment and without consultation. Includes </li></ul><ul><ul><li>self-treatment </li></ul></ul><ul><ul><li>Advice given by non-professional </li></ul></ul><ul><ul><li>Healing in a self help group </li></ul></ul>01/19/10 Medical pluralism_Yusuf Misau
  11. 11. The popular sector <ul><li>The MAIN PLAYER- the real site of PHC (70-90% of health care takes place within this sector) </li></ul><ul><li>The family- usually the women (mothers/grandmothers) </li></ul><ul><li>Both patient and healer share similar assumptions about health and illness </li></ul><ul><li>Includes a set of beliefs about health maintenance </li></ul><ul><li>‘ correct’ behavior for preventing ill health </li></ul><ul><li>Food, use of amulets </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  12. 12. The popular sector <ul><li>The individuals who tend to act as a source of health advice more often than others </li></ul><ul><ul><li>Those with long experience of a particular illness </li></ul></ul><ul><ul><li>Those with extensive experience </li></ul></ul><ul><ul><li>The paramedical professions –consulted informally </li></ul></ul><ul><ul><li>Doctors spouses </li></ul></ul><ul><ul><li>Hairdressers, salesmen, bank tellers, religious teachers </li></ul></ul><ul><ul><li>Organizers of self help group </li></ul></ul><ul><ul><li>Members of healing cults/ churches </li></ul></ul>01/19/10 Medical pluralism_Yusuf Misau
  13. 13. 01/19/10 Medical pluralism_Yusuf Misau The folk sector
  14. 14. The folk sector <ul><li>Healers specialize in forms of healing that are either sacred or secular or a mixture of both </li></ul><ul><li>Not part of the official medical system </li></ul><ul><li>Example: </li></ul><ul><ul><li>Secular, technical experts : bone setters, midwives, tooth extractors, herbalists, Boka (Nigeria) </li></ul></ul><ul><ul><li>Spiritual healers, clairvoyants, shamans, bomohs </li></ul></ul>01/19/10 Medical pluralism_Yusuf Misau
  15. 15. The folk sector <ul><li>Most folk healers share the basic cultural values and world view of the communities in which they live including beliefs about the origin, significance and treatment of ill health </li></ul><ul><li>Approach is holistic </li></ul><ul><li>Balance between people and their social, natural and supernatural environments </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  16. 16. The folk sector <ul><li>Characteristics: </li></ul><ul><ul><li>Little formal training </li></ul></ul><ul><ul><li>Informal networks </li></ul></ul><ul><ul><li>Frequent involvement of the family in diagnosis and treatment </li></ul></ul>01/19/10 Medical pluralism_Yusuf Misau
  17. 17. Advantages <ul><li>Frequent involvement of the family in healing rites </li></ul><ul><li>Most effective PHC -Can influence the society </li></ul><ul><li>Healing takes place in a familiar setting </li></ul><ul><li>Not separated by class, economic position </li></ul><ul><li>Doctors tell what has happened , folk healers tell why </li></ul><ul><li>Docs tend to place the patients ill health in a limited temporal frame and to localise it to a particular part of the body </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  18. 18. Limitations <ul><li>Training- little formal training </li></ul><ul><li>Born into a healing family etc </li></ul><ul><li>Open to abuse </li></ul><ul><li>Techniques used may be dangerous </li></ul><ul><li>Therefore, important to view them in a balanced way, avoid over idealization and over criticism </li></ul><ul><li>Arcadian view vs barbaric view </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  19. 19. 01/19/10 Medical pluralism_Yusuf Misau THE PROFESSIONAL SECTOR
  20. 20. The Professional Sector = medical system <ul><li>The organized, legally sanctioned profession </li></ul><ul><li>Modern, western, scientific medicine, allopathy, biomedicine </li></ul><ul><li>Medical and para-medical professionals </li></ul><ul><li>An expression of the values and social structure of the society from which it arises </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  21. 21. The medical profession <ul><li>Based on a body of specialized knowledge (the content) not easily acquired </li></ul><ul><li>Has a collegial organization </li></ul><ul><ul><li>Maintain control over their field of expertise </li></ul></ul><ul><ul><li>Promote their common interests </li></ul></ul><ul><ul><li>Maintain monopoly of knowledge </li></ul></ul><ul><ul><li>Protect themselves from competition </li></ul></ul><ul><ul><li>Monitor the competence and ethics </li></ul></ul><ul><li>Hierarchies of knowledge and power </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  22. 22. Alternative and complementary medicine <ul><li>Overlaps both folk and professional sectors </li></ul><ul><li>Examples: acupuncturists, homeopaths, chiropractors, osteopaths, herbalists, naturopaths, hypnotists, massage therapists, meditation experts </li></ul><ul><li>Rapidly growing in popularity </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  23. 23. Issue <ul><li>Integration of TCM into the medical system (WHO- 1978) </li></ul><ul><li>Definition of traditional medicine –not clear </li></ul><ul><li>Assumption of the efficacy not justified – egs inability to cure malaria, cholera, yellow fever and etc </li></ul><ul><li>Could be part of the problem </li></ul><ul><li>Success stories in MCH, AIDS prevention, treatment of mental illness etc </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  24. 24. Summarizing…… <ul><li>Medical pluralism is a wide range of therapeutic options available for the alleviation and prevention of physical discomfort or emotional distress </li></ul><ul><li>Professional sector -Official Medical system comprises of Medical, nursing and allied professions </li></ul><ul><li>Folk and the popular sector </li></ul><ul><li>Influences the choices of health seeking behavior </li></ul><ul><li>Public health implications </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  25. 25. Brainstorm……. <ul><li>In your view, how has medical pluralism impact on public health governance of your society? </li></ul><ul><li>Your ability to trash this effectively, reflects your understanding of this lecture and vice versa </li></ul>01/19/10 Medical pluralism_Yusuf Misau
  26. 26. REFERENCES <ul><li>Cecil G Helman. Culture, Health and Illness. Wright 2000 </li></ul><ul><li>David Armstrong. Outline of Sociology as Applied to Medicine. Butterworth Heinemann. 1994. </li></ul><ul><li>Graham Scambler (ed). Sociology as Applied to Medicine. Saunders 2003. </li></ul><ul><li>Rachel E. Spector. Cultural Diversity in Health and Illness. Pearson Prentice Hall 2004. </li></ul><ul><li>E. Gartly Jaco (ed). Patients, Physicians, and Illness. A Sourcebook in Behavioural Science and Health. The Free Press 1979. </li></ul>01/19/10 Medical pluralism_Yusuf Misau

×