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Traditional Health Practices in East Africa: Bridging Historical Legacies and Contemporary Systems

Explore the rich history and cultural significance of indigenous medicine in East Africa and its integration into modern healthcare systems. Discover how traditional healers, herbalists, and midwives play crucial roles in curative treatments. Investigate the influences of historical legacies, local environments, and regional connections on health practices. Learn about the evolution of healthcare infrastructure in the region and the challenges and opportunities faced by practitioners.

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Traditional Health Practices in East Africa: Bridging Historical Legacies and Contemporary Systems

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  1. Health Care Infrastructure East Africa

  2. indigenous medicine (review from Friday) • Practitioners • Divination (diagnose via material devices or inspiration) • Spirit Mediums – exorcise or integrate spirits, or propitiate • Rainmakers (or rain controllers) • Herbalists • Midwives • Medicine • curative treatment • restore and protect • some things activate medicines, e.g. v. sorcery • Incorporated innovations • Swahili – mganga; Luganda - omusawo

  3. parameters for contemporary health systems • Historical legacies • Environment • Local, social, cultural • Political landscape • Regional and International connections

  4. Parameters for contemporary health systems • Historical legacies • Missionaries • Colonialism • Doctors 2nd largest group recruited into British Colonial Service after Admin Officers (Crozier, 2007) • Alternative to being Missionary; Empire; Adventure • New discipline of “Tropical Medicine” • Focus of work • Diseases • Prevention

  5. Parameters for contemporary health systems • Historical legacies • South Asian sub-assistants • Training of African Health Care providers (see Iliffe, 1998) • Missionary trained ‘semi’ - professionals • African Native Medical Corps (WWI) • “Tribal” dressers – rural areas • Disease campaigns • E.g. versus Yaws , (1920s – 1930s) • Mengo University ….Makerere University • Mulago Medical School – clinical emphasis, est. 1927

  6. factors • Human Resources – Work force • Not just doctors and nurses • Who staffs…? • Pharmacies • Labs • Training facilities • Administrative and finance • Record keeping • administration

  7. factors • Physical – facilities • Institutional mix • Cultural expectations • Legal Framework • Licensing, malpractice, insurance • Providers • Public • Private (…for profit) • Voluntary (…non-profit) • Type of approach

  8. approaches • Approaches • Allopathic/ conventional/ ‘modern’ /western • Complementary, Alternative and biosocial • ‘traditional’ / indigenous • Western alternatives – osteopathic, homeopathic, chiropractic, etc • Eastern alternatives – Chinese, Ayurvedic, etc • Influence of latest donor concern / trend / fad … e.g… • Decentralization and community decision making • Monitoring and Evaluation • Integration

  9. Some East African Institutions

  10. Issues from articles • Surgical work force • Attrition of work force • Cost of migration • Central control and standards (including safety) • Local knowledge of local needs • Role of local politics and patronage • Technocrats versus politicians • Complex mix of agencies involved in hiring (Tanzania)

  11. Issues from articles • Administrative theory • You stand where you sit… • Recruitment and socialization within organization • Organizational goals (health care philosophy) • Efficiency, effectiveness, equity • Accountability, Standards • Decentralization • Deconcentration • Delegation • Devolution • Privatization

  12. Influence of Politics…

  13. Health care systems – Big Business • USAID funded Health Systems 20/20 • Health Systems 20/20 (2006-2012), funded by the United States Agency for International Development, is the Bureau of Global Health’s principal project for health system strengthening. • http://www.healthsystems2020.org/ • Useful collection of resources… sample • CSIS Global Health Policy Center • The Global Health Policy Center is a leading policy research institution focused on building bipartisan awareness about global health and its importance to U.S. national security.Including the Forum on Advancing U.S. Leadership in Global Health • http://www.smartglobalhealth.org/

  14. Health care systems – Big Networks.. • Global Health Europe • promotes synergy between the policy spheres of public health, foreign policy, development, and research for health. Not-for-profit, non-partisan platform and think tank. • http://www.globalhealtheurope.org/ • Global Health Security Initiative (GHSI) • informal, international partnership among like-minded countries to strengthen health preparedness and response globally to threats of biological, chemical, radio-nuclear terrorism (CBRN) and pandemic influenza. • http://www.ghsi.ca

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