Trial Lecture – time and place
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Adjudication committee
- First opponent: Professor Asma El Sony, Epidemiology Laboratory (Epi-Lab) Sudan
- Second opponent: Professor Sven Gudmund Hinderaker, University of Bergen
- Third member and chair of the evaluation committee: Professor Christoph Gradmann, University of Oslo
Chair of the Defence
Professor Emeritus Bjørn Myrvang, University of Oslo
Principal Supervisor
Senior Researcher Fekadu Abebe, University of Oslo
Summary
Tuberculosis (TB) kills an estimated 2 million people annually worldwide. TB affects poor and marginalized population such as pastoralists due to poor access to healthcare, low knowledge about TB, consultation of traditional healers (THs) for their illness, seasonal migration, and poor adaptation of the national TB control strategy to the pastoralists’ way of life.
The aim of the thesis was to understand socio-cultural challenges and opportunities for TB control in a pastoralist community in Ethiopia. The study used semi-structured interview and focus group discussion among selected residents, THs and healthcare providers (HCPs) to assess knowledge, attitudes, and stigma. In addition, the effectiveness of involving THs in TB control programs in the district was assessed by a pilot interventional study through initiating referral links between THs and healthcare facilities.
The pastoralists and the THs in this community were aware of the basic symptoms of TB. However, most of the pastoralists had low overall biomedical knowledge regarding TB compared with their neighboring sedentary residents.
A substantial proportion of the pastoralists, the sedentary group, the THs as well as the HCPs had attitudes, which does not favor effective TB control and management. In addition, the pastoralist community had high-perceived stigma regarding TB compared with their neighboring sedentary group (68% vs. 20.2%, p<0.001), respectively. In addition, both pastoralists and THs in the community migrate during dry season.
Results of the pilot intervention study showed the importance of community engagement for effective TB control in the district; more importantly, the willingness of the HCPs and the THs to collaborate in TB control activities in the community.
Overall, considering the socio-cultural challenges, the study underlines the need to consider THs in planning TB control programs pertinent to pastoralists’ way of life.
Additional information
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