Exploring the contribution of indigenous medicine to primary healthcare in West Belesa District in northwestern Ethiopia: A qualitative analysis

Background: This study explores the contribution made by indigenous medicine to primary healthcare services in West Belesa Woreda (District) in northwestern Ethiopia. Objective: The study aims to examine the practices of indigenous medicine in three communities in West Belesa Woreda, the perceptions of its use and efficacy among indigenous medical practitioners and biomedical healthcare practitioners, and their views on its role in primary healthcare. Methods: Qualitative research, including in-depth interviews, focus group discussions and direct observation, using an ethnographic design, was conducted from February to April 2017. In total, 16 key informants were interviewed and six focus group discussion sessions were held. Thematic analysis was undertaken to analyze the data. Results: The local pluralistic healthcare system employs both indigenous medicine and biomedicine, often in combination. However, indigenous healing is generally the first choice due to its greater availability, affordability, and cultural acceptability. Malaria, intestinal worms, diarrhea, stomach ache, gastritis, wounds, snake bites, and epilepsy are commonly treated by herbalists with medicines prepared from plants and plant products. Illnesses that are perceived to be due to buda (evil eye) and spirit possession are mostly treated with tsebel (holy water), prayers and spirit exorcism. The findings also show that most modern healthcare providers have negative perceptions towards indigenous medicine, mainly because it lacks standards for prescribing medications. On the other hand, some beneficiaries of indigenous medicine asserted that indigenous healers provide better primary healthcare for spiritual illnesses and bone fractures. Conclusions: Understanding the cultural context of health, illness, and healing, and the involvement of indigenous healers in primary healthcare, may facilitate the provision of compatible treatments consistent with Amhara cultural and religious traditions and the integration of indigenous medicine and biomedicine. [Ethiop. J. Health Dev. 2020; 34(3):191-204] Key words: Indigenous medicine, primary healthcare, qualitative analysis, Ethiopi