why integration of TCIM with primary health care services is key

As a country rich with traditional, complementary and integrated medicine (TCIM) practices, Ghana is making steady efforts to improve evidence-based, quality delivery of TCIM in the country. We caught up with Dr Anastasia Yirenkyi, Director Traditional and Alternative Medicine, Ministry of Health Ghana, to discuss the TCIM experience in the country and future directions to better serve the needs of communities.  


What has been Ghana’s experience in developing TCIM? 

Traditional medicine is based on knowledge that had been a part of faith and belief systems that people used throughout the time in Ghana to improve their health and well-being. Since 1960s, there has been a consistent political leadership in the country to develop policies and standards of TCIM delivery. 

In 1975, Ghana established a centre for plant-based medicine. We now have a centre of excellence for research and development of herbal medicines, working with universities. Many efforts have been made to provide professional trainings, and we have a very strong Federation of Ghana traditional medicine practitioners. We have good policy and regulatory framework under the Public Health Act 851 mandated to control medical products including herbal medicines.  

Since 2017, we started pilots to integrate TCIM as part of primary health service delivery in the public health sector. Now we have 55 TCIM services integrated in the public health facilities. But we need to do a lot more. Not only in Ghana but also in the the whole African Region, we need to identify gaps and build bridges between the traditional and conventional medicine, to work together. 

Anastasia Yirenkyi, Ghana

What has been the experience in improving quality and safety standards of TCIM practices?  

Implementing the Public Health Act 851, we have been making efforts to register and accredit TCIM practitioners. We promote a common Code of Practice for TCIM. We estimated there are at least 40 000 practitioners of various TCIM practices in Ghana. At MOH, we have registered up to 10 000 of them. This means we have a lot of work to do, not only in Ghana, but in all of our countries.  

TCIM practices are located at the centre of communities; people go to them because they know them, they speak their languages, know their customs and traditions. In many settings, TCIM practitioners provide the essential primary health care. In the past, they mostly used to operate in the private sector, so even educating them about the regulations and safety standards require a lot of efforts. This also means we need a lot of support from partners and collaborators to invest in this work.  

What is the most important action we should take to improve delivery of TCIM? 

Building bridges between communities is much needed. We invite many conventional medicine researchers and doctors to events such as the African Day for Traditional Medicine, or conventions organized by the West African Health Organization. We learn so much from each other, there is so much missed opportunity to understand how different types of medicine can collaborate to help people get healthier.  

Equally, integrating service delivery focusing on patient-centred care is so essential. We need to promote referral services; for TCIM practitioners to say for example, if the patient requires urgent care from conventional medicine–let’s say, has a high blood pressure or symptoms of infectious diseases–to refer to the needed care in conventional medicine clinics so that patient doesn’t miss the required early diagnosis and care. At the same time, conventional medicine providers can refer to TCIM care if the patient expresses interest to access TCIM interventions and can benefit from it. This kind of collaboration and integration can help deliver a truly holistic care for people to achieve better health and well-being. 


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