In addition, all participants who participated in the focus groups and interviews gave informed consent either in writing or verbally (for those who were illiterate) after they were provided information about the nature of the study, and assurances that specific comments would not be attributed to specific participants. People in our village sterilize the equipment they use for these purposes. Federal government websites often end in .gov or .mil. The current Ethiopian indigenous health strategy (the National health strategies with regard to Indigenous Solution reported in March 2015) acknowledges the need to support components of indigenous medication including recommendations to explore potential beneficial aspects [31]. Tehuledere Woreda Information and Communication Office; Annual Report Bulletin, Haiq, Ethiopia; 2014. Soc Sci Med. Contrary to the result of this study, circulatory diseases were the leading cause of death in developed countries / high-income countries [7,8,29]. Functionalists also study culture in terms of values. In Ethiopia, people use indigenous medical systems as an alternative health care service along with the biomedical health services [1, 6]. Almost all the focus group participants identified better food production as a contributor to health: We keep healthy when we produce enough food and have work to do. The first authors (MHK) native status offered both opportunities and limitations for the study [19]. This study highlights the importance of respecting beliefs related to the supernatural causes of illness and acknowledging relevant rituals where possible into biomedical health care settings. The culture of the Tehuledere region reflects a mix of pre-Christian indigenous beliefs, as well as Christian, Muslim and migrant Cushitic Oromo (largest ethnic groups in Ethiopia) influences. volume17, Articlenumber:124 (2017) Constructing evidence within the qualitative project. The French chemist and microbiologist Louis Pasteur, the English surgeon Joseph Lister, and the German physician Robert Koch are given much of the credit for development and acceptance of the theory. Galenhad written of the possibility of seeds of disease, a view which suggested a belief in the contagious nature of some diseases. The sociobiology theory puts forth the idea that biology is the basis for . In contrast a stable home and family was seen as an important contributor to health. Federal Ministry of Health. . Due to restrictions set by the Addis Ababa University, College of Health Science Institutional Review Board, data are available upon request by contacting the corresponding author. Tooth decay, measles, or a broken bone are examples. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. In: Morse JM, Swansen JM, Kuzel A, editors. Our study provides an excellent example of why health education and primary health care delivery interventions need to take into account what people actually do and the beliefs that drive their actions. In clinical medicine we are confronted by a patient P with certain complaints, and eventually a diagnosis is reached because the clinical findings suggest that P has a certain disease D.Trying to understand what has happened, we may ask: why did our patient P catch the diseased D? The sample was diverse in terms of age and sex and agro-ecological condition of the setting. An official website of the United States government. Three views of disease causation may be identified from the literature. EMJ. Not everyone finds it easy to do the exercise recommended by the NHS - two out of three people say they do less than 150 mins (2.5 hours) of moderate exercise and fewer than one in 10 manage more . Hippocrates; Yellow Bile, Black Bile, Phlegm and Blood Miasma Theory: 500 BC Miasmas are poisonous emanations from putrefying carcasses, vegetables, molds and also the invisible particles. The dominant frameworks argue that culture is a set of values, beliefs, and actions that are learned through interactions with others. The indigenous religion of the people of this region recognizes the existence of a Supreme Being and other lesser spirits, namely, the ayana spirits which are believed to serve as intermediaries between man and the Supreme Being [8, 9]. Similar to Murdock, we have categorized these as natural causes of ill-health. Helman (1990) presentation of lay theories of illness causation identified four sites; individual patient, the natural Google Scholar. Medical and cultural considerations. Similar to Murdock, a key category of causes of ill-health was the supernatural described by members of the study community as forces capable of putting spells on human beings. Ali A. In the early past, the disease was thought mainly due to either the curse of god or due to the evil force of the demons. Choosing among five traditions. Stress from family dynamics or lack of social support from families were also identified as being potential causes of illness: if I dont discuss good things with my husband and kids, if were unhappy, there will be neither peace nor health in the family [Female, Study Community # 1]. The site is secure. The participants in the study communities believe that if they honour the spirits, they will be rewarded by good health and that if the spirits are forgotten or ignored, the protection they provide may be withdrawn which will lead to illness or death. BEINGS Model of disease causation includes Spiritual factors , Social factors & Nutritional factors. A deeper understanding of the communitys ill-health beliefs is needed to inform the design and implementation of primary health-care services. Or if A decreases, B correspondingly decreases. Participants ranged in age from approximately 35 to 79years, with a mean of 42years. FOIA The disease is said to pass onto seven generations. hbbd```b`` (0 (d9 lz`&&$ D&2$#dB@@lHDIe7sL@o30"? Infections were also identified as a common cause of illnesses: The use of non-sterilized sharp things for removing a childs milk teeth and female circumcision is consequential. Download Free PDF Qolle spirits are mostly venerated by buttering the natural objects, burning incense, tying around these objects strips of ropes or even a bunch of hair [Female, Study Community # 5]. However, others acknowledge that indigenous medicine should be embraced as an important part of health care systems in indigenous communities [35]. Various social, cultural, and religious norms produce and reinforce gender inequality and the stereotypical gender roles that underpin gender-based violence. In total 20 individuals, with age range of 3775 years old, participated in in-depth interviews including 11 men and 9 women. Mystical causes are often attributed to experiences or behaviors such as ancestral retribution for unfinished tasks or obligations. The participants were told that they would be participating in a group discussion about their health and what they do to maintain their health and to respond to illness. Following introductory discussions with community leaders/representatives, ten focus group discussion sessions (one all male and one all-female in each kebele) were conducted. doi:10.1177/1049732310362400. Nature of qualitative evidence. 2022 Apr;10(4):893-900. doi: 10.1016/j.jaip.2022.01.010. Meadows LM, Morse JM. Epub 2022 Jan 7. The breakthrough came in 1860, when the French bacteriologist Louis Pasteur (1822-1895) demonstrated the presence of bacteria in air. Finally the themes were incorporated into a conceptual model of the participants and their beliefs and perceptions in illness causation [18]. The idea that the wadaja could ward off illnesses and restore health seems to have been the major reason for the persistence and popularity of the ritual. Ulin PR, Segall MH, editors. Our study highlights the importance of understanding the perceptions of causes of ill health and disease in the study communities as a guide to how best to implement public health initiatives in the region. Felipe-Dimog EB, Tumulak MJR, Laurino MY, Daack-Hirsch S, Silao CLT, Conaco MCG, Padilla CD, Estacio LR Jr. J Community Genet. In addition to their physical inaccessibility, biomedical health services are often unaffordable. Atkinson S, Haran D. Individual and district scale determinants of users satisfaction with primary health care in developing countries. Wilson. We also found acts in violation of social taboos or moral injunction were thought to cause illness directly rather than through the mediation of a supernatural being. Germ theory emerged in the 19th Century, but it built on two notions that had earlier incarnations. Similar to other cultural groups in developing countries around the world [11], many of the Tehuledere people attribute illness to the wrath of supernatural forces. This study aimed to explore the socio-cultural context of indigenous beliefs regarding ill-health among five Tehuledere communities found in the Amhara Regional State of Ethiopia. PubMed Like all research, out study has both strengths and limitations. However, the capacity to execute and give expanded resources to support the sustainable utilization of indigenous medicine and implement health strategies that take into account indigenous ill-health beliefs is constrained. A valuable and interesting world survey of aboriginal theories of disease causation has been made by Clements.1 The types and distributions of ithe theories which he pre-sents embrace well the main methods of interpreting disease in simpler societies; yet the basic analysis of disease causation concepts which he employs needs a little further New York: Macmillan Publishing Co.; 1970. p. 31527. For example, if a man cheats on his wife, this could cause illnesses: A person will be healthy when he settles at home, and is not cheating on his wife. Indigenous people often believe that Western trained doctors are not equipped to address their concerns which are can include spiritual as well as physical concerns [2]. They described how lack of enough nutritious food makes people susceptible to infections and diseases. The health extension workers also helped to select 96 participants for 10 focus group discussions and 20 individuals (two from each focus groups) were selected purposively for follow-up individual interviews based on their demonstrated knowledge and ability to describe their experiences in the focus groups. The study was approved by the Ethical Review Committee in the College of Health Sciences Addis Ababa University, with either in writing or verbally (for those who were illiterate) consent to participate in the study being obtained from all study participants. Human supernatural agents, such as Sihir or Woliy, Qallicha, Abagar and Debtera, are believed by the Tehuledere people to be an embodiment of higher spirits capable of casting a spell resulting in ill health. It is hoped that the model of illness causation identified in this study will help to enhance the rural health plan for the 5 villages of Tehuledere Woreda and beyond. Before Example: the more purchases made in your app, the more time is spent using your app. Waddel A, Petersen AR. It involves praising and glorifying the sky-god and seeking his spiritual assistance to ward off evil. We will also share examples on how these common beliefs provide explanation as cause of illness and its implications in our genetic counseling profession. The move towards a new public health police. 1983;17(16):120511. Murdock G. Theory of illness. By accepting, you agree to the updated privacy policy. Even when a pathogen is the principal cause of a disease, environmental and hereditary factors often influence the severity of the disease, and whether a potential host individual becomes infected when exposed to the pathogen. Part of Similarly, a theoretical approach initially used to frame and subsequently to interpret the data from this study allowed for a more thorough explanation of beliefs and perceptions of illness causation. For example, Wadaja, a communal prayer ceremony, is a common rite practiced in Tehuluedere. The practice of epidemiology. We would also like to acknowledge the University of Toronto for giving the first author an opportunity to obtain advanced training in qualitative data organization and analysis during a visit to Toronto, Canada. Creswell JW. Sanders Thompson VL, Johnson-Jennings M, Baumann AA, Proctor E. Use of culturally focused theoretical frameworks for adapting diabetes prevention programs: a qualitative review. This . J Hum Lact. 2005;60:50113. Indian Veterinary Research Institute, Izatnagar-243122, Ultimately, these diseasesdisproportionately affect people living in poor or marginalised communities. 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