Background and Purpose:

Patronage of Traditional Bone Setters (TBS) in Northern Nigeria, just like other parts of country, is enormous. However, plans to formalize TBS practice into mainstream health systems are contentious and debatable. This study investigated the practice of TBS in Katsina State, Nigeria.

Relevance

Traditional medicine practice is an important aspect of the primary health care delivery system in northern Nigeria, though with attending challenges such as non-compliance and poor infection control.

Participants/Subjects

Twelve TBS were identified but only nine consented to participate in the study, yielding a response rate of 75%.

Methods

A qualitative method using ethnographic approach which is based on observation-participation technique was adopted. The first key informant in the study was purposively recruited while others were identified using snowball technique. In-depth Interview (IDI) was used to collect data. The IDIs were transcribed verbatim and translated into English from Hausa. Thematic content analysis was used to organize data.

Analysis

The IDIs were transcribed verbatim and translated. Based on grounded theory, content analyses of key themes and phrases were used to organize data and sections on narration were presented. Short descriptive codes were allocated to sections of the text, then codes expressing similar concepts were grouped together to form themes. The allocated codes were used to summarise and synthesize the data. Codes and themes were compared across scripts. During the coding process, literature was used to support the allotted labels and their properties.

Results

The results were presented in narrative and thematic formats. In sum, traditional bone setting practices in Katsina is heterogeneous but has both spiritual and traditional underpins. The TBS manage fractures and dislocations as the predominant cases, as well as, a wide range of other conditions affecting human and animals. Complications resulting from TBS practice were partly blamed on patients’ attitude while referral to other TBS or hospitals, and prescription of antibiotics were often employed in the face of complications

Conclusions

This study shows that TBS in northern Nigeria lacked basic knowledge of human anatomy; formal training on infection prevention, hygiene and referral systems is poor among these practitioners. Common challenges faced by the TBS includes non-compliance to instruction by the patients, and lack of facilities, ability to pay bill, and transportation.  Support from governments and integration of TBS practice into the health systems was advocated.

Implications

This report raises issues that bother on quality of care provided by practitioners of traditional bone setter in northern Nigeria and the attending challenges of this mode of healthcare delivery. Some Asian and African countries have established acts and laws to regulate traditional medicine practice but this is yet the case in Nigeria

Keywords

Humans; Fractures; Anti-bacterial agents; Hygiene; Patient compliance; Joint dislocation

Funding Source Acknowledgement

This work was unfunded

Ethics approval

Health Research and Ethics Committee of the Institute of Public Health, Obafemi Awolowo University, Ile-Ife, Nigeria  (IPHOAU/12/296) provided approval.