Culture and Health Care |
A Review of Culture on Health Disparities, Health Related Practices and Healthcare Outcomes
The social status of an individual refers to the rank one holds within a group or community; and requires conformance to such rights, lifestyle, and duties as understood by prestige and social hierarchy (Encyclopedia Britannica, 2016). Status may be attained or ascribed in different ways. One, for instance may inherit such status at birth as it happens in monarchies and Kingships. This kind of status climb has nothing to do with one’s innate abilities or skills. Ascribed status is based on such factors as age, family relations, lineage, birth, sex, and similar considerations while acquired status is earned. It may be based on such factors as the level of education, marital status, occupation and similar factors that come with accomplishment of certain feats that required some practical effort.
Status is about scale stratification. The notion of high position in society is based on the ability of one to control other people’s lives in some way. Such control may be by law, order or by influence. Relative status is a strong influence on people’s behavior towards each other. Generally, status varies with social context. For example, one’s position within the family often determines the perception by others in the wider community. Occupational consideration is also an important factor that influences the perception of status. In industrial economies, such factors as the ability to consume certain categories of goods, a respected occupation, attire, physical appearance, one’s manners and general etiquette have increasingly become a yardstick for determining status; a departure from the traditional culture, being pinned on lineage. Occupation in the industrial society is based on a continuum. There is no stiff or rigid hierarchy. Status is closely linked with morality and etiquette and in most modern societies today, has become a function of wealth (Encyclopedia Britannica, 2016).
In Africa, in many societies, a host of factors including their place of origin and family relations determined the social status of an individual. For example, if one was born in a wealthy family or one that had close friendly links with an influential, powerful or rich family, such a person’s social status would be higher than others who belonged to lesser families. The converse was also true if one was born into a poor family.
Furthermore, being a male carries a superior status to that of a female. Such perceptions still hold to a certain extent but they are high breeds of a mix with western influences such as western education and perception of status. Therefore, in addition to considering aspects such as sex, age and wealth, factors such as the level of education and occupation are strong markers of one’s status. Indeed, accomplishments are also a strong indication in the new considerations.
Cultural Habits and Health
African culture is passed from one generation to the next. It is important to note that Africa is not one large entity with identical cultures and people. The cultural content in the continent is diverse; just as its people, societies, and identities. Nevertheless, the majority of African cultures believed in the existence of a supreme being. They believed that such (supernatural) a being created humans and endowed them with resources such as land and rivers, animals and similar abundance that was critical for survival. The Supreme Being is known by different names in different communities. The commonality is that the Supreme Being is the creator of the universe. He is the provider and can cause life and death. African cultures, like cultures from many other regions of the world have also been subject to western influences. Thus, the belief in the existence in a single supreme being is one of the influences of such interaction and is called God.
People’s cultural practices and habits, both affect not only their health but also other aspects of life. These aspects include their social relationships, their contribution to the health of society, and its functioning. Their immediate social environment affects humans. Different communities and races have unique cultural inclinations and beliefs when it comes to disease and health matters. These unique ways of approaching social and cultural aspects of life also influence the way people view, respond to and manage health matters that confront them (Asu, Gever & Joshua, 2013).
Traditional cultural practices and values are still at the heart of many African societies. Analysis of African culture often presents two versions. The style of naming children is one of the most conspicuous and resilient symbols of African culture. Others that are still strongly laced with African tradition and culture include marriage and initiation ceremonies. According to Asu Gever &Joshua (2013), attitude towards health and community practices influence the way people make use of healthcare facilities.
Factors that influence how people receive healthcare services in Africa vary from community to community and country to country. Consequently, they yield varying results and the spread of different types of diseases. Some of the observable factors include
Religious beliefs: moral issues, religious practices, and beliefs affect health significantly. Commonly, in cases where a victim suffers from a serious illness, it is attributed to the wrath of gods. Indeed, it is not uncommon to hear of the anger of ancestral spirits. African religion incorporates ancestral spirits as a central element in its practice. These spirits are closely knit with people’s lives. Many African communities hold that all living things are harmoniously connected with the spirits and the gods. In that relationship, there is ascribed special force that each of them generates.
When there is perfect harmony with the environment; spirits and the gods, a state of peace is experienced. These are staunch beliefs held by African Traditional Religion adherents. It is also a belief that is shared among Muslims and Christians alike. Misfortune and even ill-health, that defies modern medicine are believed to be spiritual forces controlled by sorcerers, wizards and witches; or simply as manifestations of the ancestors’ wrath on the society.
Indeed, according to African belief, one does not simply just fall ill. There is always a major supernatural connection when it comes to serious illnesses. Viral, parasitic or bacterial causes of illness are generally viewed as secondary causes of the problem at hand (Asu, Gever & Joshua, 2013).
Traditional African Medicine (also called TAM): Traditional African Medicine has been a specialty of rural dwellers for a long time. Conventional medicine is also in short supply, or fake or just too expensive for the commoners in these places. The consequence of these realities is that people’s health is then anchored on TAM; because it is easily accessible and rarely bears negative perceptions of not being the real thing. Indeed, many African people strongly believe in the effectiveness of TAM. These beliefs have had a strong influence on their personal attitudes and behavior towards others including new developments in modern medicine. Generally, an average rural dweller calls on TAM for treatment and management of fractures, malaria, poisoning, mysterious ailments, infertility among others. It cannot be denied that the spread of education and civilization have had a strong influence on the level of patronage that modern medicine receives from the African folk; studies demonstrate significant achievements in the practice of Traditional African Medicine. TAM, however, faces such issues as standardization, efficacy, and medicine complications have and their share of negative publicity when it comes to TAM. Practitioners of Tam have made claims to panacea-like effects of their medicines hence, there have been more deaths recorded among the rural folk; who also happen to form the largest clientele for African Traditional medicine usage. It has been noted that it is only when the claims by the practitioners of TAM do not meet the expectations, that victims rush to conventional medicine vendors and chemists for alternative help. The practice of TAM constitutes divinations, ritual sacrifices, confessions, and plant and animal potions. These are central elements of management of illnesses. These aspects of therapy are meant to restore the patient’s harmony with the environment; the spirits and the gods and fight the forces of evil believed to be creeping in. The most conspicuous reason for patronizing term yet, is that nearly every condition is believed to be influenced by spirits; thus, they all need traditional healing techniques (Asu, Gever & Joshua, 2013).
Denying reality: Many rural dwellers, in Africa, seem to be at conflict with the reality; with regard to the treatment and handling of chronic ailments such as asthma, bronchitis, diabetes mellitus arthritis, epilepsy, hypertension and others. Most of them conclude after several checkups and follow-up treatment that orthodox medicine fails is providing a lasting solution to such ailments and, thus, opt for TAM. It has also been noted that when people envision a dead-end to treatment efforts; especially on such illnesses as coma, tetanus, terminal and cancer, they opt to leave healthcare attention and seek intervention from TAM practitioners (Asu, Gever & Joshua, 2013).
Traditional Beliefs and Values
Cultural practices of a community are normally a reflection of their lifestyle over generations. All social groupings around the world have specific traditional norms and practices. Some of the practices are helpful to the society members. Some of the practices could be harmful or non-supportive of certain groups, including women. Most African people hold their traditional beliefs and customs dearly. While some of these practices have long proven to be helpful, others have also been found either not to add any value or out-rightly harmful. Some of the harmful practices that have proved hard to weed out or voluntarily drop include female circumcision. Others include feeding women forcefully, early marriage, preventing women of taking charge of their fertility, taboos to do with nutrition and birth practices as dictated by traditional beliefs. There are also other practices that affect the career and educational progression of females, female infanticide, dowry and early pregnancy. Many of these latter practices are outlawed in the countries where they are conducted but there is little probing and questioning of their occurrence. In fact, they even assume an aura of moral value in the eyes of the proponents (Mhame, Busia & Kasilo, 2010).
Healthcare Practice and Systems
Health is a state of wellbeing that allows one to carry out their life activities in the measure expected of their age, culture, and responsibility, and in a bid to satisfy their life’s needs and demands. It may also be defined as a state of wellbeing, characterized by freedom from infirmity or disease. It is also regarded as a basic human right. WHO defines health as a state of complete mental and physical well-being. The principle of Health care and clinical practice is to evaluate the state of ill health and prescribe the best ways to manage it (Mhame, Busia & Kasilo, 2010). Mhame, Busia and Kasilo (2010) point out that African clinical medicine practices combine rehabilitative, preventative, and training services and refer to them as clinical practices. Such health care interventions are accessed via culture and tradition that is carried out ascribing to a specified philosophy. Examples include Ubuntu and Unhu. The taboos, norms, culture, and the traditional medicine are the cornerstones that influence acceptability of traditional practitioners of healthcare in the communities they are offered. The philosophies behind the practice of such traditional medicine as a form of clinical care are the reason that these services have stood the test of time. Health services in African culture and tradition span a wide range of aspects and services such as bone setting, midwifery and mental health services.
Disparities refer to the unequal and imbalanced/ discriminative provision of health services. Health disparities are a common and longstanding problem in many societies. This is characterized by some members of the community receiving better health service and more readily than others. Poor health services, of course result in poor health outcomes among the deprived groups. Disparities take different shapes including disproportionate access to health insurance cover among populations. In African societies, people with low income and those with lower education are more likely to remain/be uninsured. Access to health care services is greatly impeded by low income. People in these brackets, often, experience poor health outcomes (Artiga, 2016).
Asu, O. T., Gever, I. D., & Joshua, N. P. (2013). African Cultural Practices and Health Implications for Nigeria. International Review of Management and Business Research, Vol 2, Issue 1, 176-183. Retrieved from http://irmbrjournal.com/papers/1367572222.pdf
Artiga, S. (2016, August 12). Disparities in Health and Health Care: Five Key Questions and Answers. Retrieved September 7, 2016, from Kaiser Family Foundation: http://kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/
Encyclopedia Britannica. (2016). Social Status. Retrieved September 7, 2016, from Encyclopedia Britannica: https://www.britannica.com/topic/social-status
Mhame, P. P., Busia, K., & Kasilo, O. M. J. (2010). Clinical practices of African traditional medicine. African Health Monitor, Vol 13. Retrieved from African Health Observatory: https://www.aho.afro.who.int/en/ahm/issue/13/reports/clinical-practices-african-traditional-medicine
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