Outline of Presentation Introduction Problem Statement Research Questions Objectives of the study Study Hypotheses Methodology Conceptual Model References
Introd’n Health is an indicator of development and themechanism for achieving development (Buor, 2008). Strong health systems are fundamental to improvehealth outcomes and accelerate progress towards health-related MDGs (WHO, 2009). The enjoyment of the highest attainable standard ofhealth is fundamental right of every human being (WHO,1946; UN, 2000; Human Right Council, 2002).
Intro Cont’d Indeed, the sine qua non of large and effectivelabour force is good health (Baidoo, 2009; Buor,2008). Wealth of a nation is a function of the well-being of the people (Sen, 1987; Todaro & Smith,2009).
The Problem Health system in Ghana has gone through series of changes since independence (van den Boom et al., 2004; Sowa, 2000). With burden of diseases and escalating costs of health services, there is urgency to extend health services beyond OM (Buor, 2008; WHO, 2010; Baidoo, 2009; Mutabazi, 2008). Doctor/population ratio=1:11,929 TMP/population ratio = 1:386 (MOH/GHS Report, 2009).
Problem Cont’dSpatial disparity in health care access is criticalin Ghana (Mensah, 2008; Buor, 2008). OM has failed in handling tropical mostdiseases -malaria, piles, boils, infertility (Gyasi etal., 2011; Buor, 1993).
Problem Cont’d TM is effective/cost-effective/available to thepeople (Gyasi et al., 2011; Fokunang et al, 2011;Kuete et al., 2007; Xu & Levine, 2008; WHO, 2008). In Ghana TM is trusted and practiced in line withthe socio-cultural background of people (Kitua, 2004;Graz et al., 2011). People by choice or necessity rely on TM forprimary health care needs (Gyasi et al, 2011;Tchiakpe, 2004).
Problem Cont’d Some studies associate the TM use withdemographic/socio-economic characteristics of patients(Peltzer, 2008; Dhalla et al, 2006; Thomas et al, 2007;Aydin et al, 2008; Mensah and Gyasi [in press]; Lorenc etal, 2009; Chao and Wade, 2008). There are other complex psycho-social, cultural andbelief factors (Gyasi et al, 2011; Osamor and Owumi,2010; Menniti-Ippolito, 2002; Bishop et al, 2007). Findings are mixed and not well understood.Investigating the determinants of use of TM in Ghanabecomes relevant.
Research Questions What demographic, socio-economic & psycho- social factors are associated with the use of TM in Ghana? Are there any differences in the utilization of TM between rural and urban areas in Ghana? To what extent does the NHIS impact the pattern of use of traditional medical services. What are the factors that militate against the efforts to integrating the TM into the mainstream health care delivery in Ghana?
Study Objectives Examine the predictors associated with the use ofTM in Ghana. Attempt a comparative analysis of the use of TMbetween rural and urban communities in Ghana. Investigate the impact of NHIS on the pattern of useof TM in Ghana. Analyse the determinants of integrating TM into themainstream health care system in Ghana.
Study Hypotheses The research will be based on the following hypotheses: Household income level does not show association withutilisation of TM. The education level does not influence the use of TM. Residential status has no association with the TM use inGhana. Affective behaviour of TMPs does not show a strongrelationship with the utilisation of TM. National Health insurance status has no relationship withutilisation of TM in Ghana.
Methods The study design Cohort and cross-sectional survey (Buor, 2004). Mixed method of quantitative & qualitative approaches (Trochim, 2006; Mack et al, 2005). The variable Response variable: utilisation of TM. Explanatory variables: demographic (eg. Age, sex), socio-economic (eg. Income, education), psycho-social (eg. Belief, culture) and accessibility factors (eg. Cost, availability).
Methods Cont’d Sampling Study Areas: Sekyere South District and KumasiMetropolis of Ashanti Study Communities: Atonsu, Tanoso, Tafo,Ayigya, Asawase, Bepoase, Jamasi, Agona,Asamang, Wiamoase.
Methods Cont’dStudy Sample & Size: Clients of TM (470), TMPs(20), OMPs (20) and key informants-MoH/GHS (2). Sampling Technique: Systematic randomsampling, snowball & purposive techniques.Sources of Data: 4-sets of primary data.Secondary information from archives & documents. Data Collection Tools: Questionnaire/ structuredinterviews (for Quantitative data) & In-depthinterviews (for Qualitative data).
Method Cont’dData Analysis: Quantitative: Bivariate/multivariate/Stepwise multiple regression techniques via PASW v.17.0; Percentages/frequency tables/charts will be used to present data.Significance: ≤ 0.05. Qualitative: Content analysis through themes & direct quotes.
Significance of the StudyIncrease knowledge and add to literature. Useful to MoH/GHS and Traditional/ Alternative Medicines Unit.Useful to WHO/WHA.
Significance Cont’dA mechanism for the actualization of Health For All Policy in Ghana. Contributes to the achievement of the health-related MDGs in Ghana.
References Buor, D. (2008). Analysing the socio-spatial inequities in the access of health services in sub-Saharan Africa Professorial Inaugural Lecture. Great Hall, KNUST, October 9, 2008. Gyasi, R. M., Mensah, C. M., Adjei, P. O and Agyemang, S (2011) Public Perceptions of the Role of TM in the Health Care Delivery System in Ghana. Global Journal of Health Science: Vol. 3, No. 2; doi:10.5539/gjhs.v3n2p40. Osamor, P. E and Owumi, B. E (2010) Contemporary and alternative medicine in the management of hypertension in an urban Nigerian community. BMC Complementary and Alternative Medicine, 10:36 http://www.biomedcentral.com/1472-6882/10/36
References Cont’dKarl Peltzer, Natalie F Preez, Shandir Ramlagan and Henry Fomundam (2008)Use of traditional complementary and alternative medicine for HIV patients inKwaZulu-Natal, South Africa. BMC Public Health. 8:255.http://www.biomedcentral.com/1471-2458/8/255Trochim, W. M. K. (2006). Qualitative Methods.http://www.socialresearchmethods.net/kb/qualmeth.php. (Accessed: March,2012).Ghana Health Service/Ministry of Health (2009) Final draft of Annual ReportGraz, B., Kitua, A. Y and Malebo, H. M (2011) To what extent can TMcontributes a complementary or alternative solution to malaria controlprogrammes? Malaria Journal, 10 (Suppl 1):S6. Available at:http://www.malariajournal.com/content/10/S1/S6