Integrating Traditional Medicine into Orthodox Practice: A Case Study of Lekma Hospital in Accra, Ghana

Abstract

Introduction: The Government of Ghana is promoting the integration of traditional and orthodox medical practice. Towards this end, the Ghana Health Service has instituted the policy of having a traditional medicine (TM) unit at each of its hospital-level facilities. Traditional medicine practitioners are also being trained and certified by public universities in the country. The Ledzokuku Krowor Municipal Assembly (LEKMA) hospital in Accra is an example of a facility which has established a TM unit since 2010. This study examined how integration has been implemented in this hospital and the challenges that have been associated with the process. Methods and Procedures: Two approaches to data collection were used. First was in-depth interviews with patients, orthodox and TM practitioners and other health professionals in the hospital. All interviews were recorded, transcribed and analyzed manually under various themes of interest. Findings are presented under the various themes with relevant and pertinent quotes from the participants. The second approach was structured observations of clinical consultations at the TM unit. This was done to identify the extent of discussions about the complementary nature of the two forms of practices. Confidentiality and anonymity of the participants were ensured through the non-use of patient identifiers. Results: Practitioners were complimentary of the practice on either side. Orthodox practitioners generally tended to be less enthusiastic. There was however no formal platform for practitioners on both sides to meet and discuss cases or the process of integration. Patronage of TM services was often for chronic ailments such as hypertension and diabetes, and tended to be by older people. Herbal medicines were the most patronized as acupuncture was considered to be a service for the affluent. Patients often requested TM treatment and medication even after they had been seen by orthodox medical (OM) practitioner. Such care was often offered without recourse to what had been given by the OM practitioner. A major concern of TM patients and practitioners was the fact that traditional medicines were not covered under the National Health Insurance Scheme (NHIS). Conclusion: There is structural integration of TM and orthodox practice at the LEKMA hospital in terms of proximity. There is however very little functional integration as the two practices worked independent of each other. Patients go between the two forms of care without the exchange of clinical information between the two sides. Care is therefore more supplementary than complementary. The issue of NHS cover for drugs bought as part of TM care needs to be addressed.