African Journal of Obstetrics and Gynecology | 04 April 2013
An Ethnographic Study of Plural Medical Systems in Kenya: A Comparative Analysis from 2000 to the Present
F, a, t, u, m, a, A, b, d, i, ,, W, a, n, j, i, k, u, M, u, t, h, o, n, i, ,, K, a, m, a, u, O, c, h, i, e, n, g
Abstract
In Kenya, plural medical systems—encompassing biomedical, traditional, and faith-based healing—coexist in the provision of obstetric and gynaecological care. A deeper understanding of how these systems interact and how patients navigate between them is needed to inform effective health policy. This ethnographic study aimed to document and compare the use, perceptions, and interfaces of plural medical systems for women’s health in Kenya. It sought to identify patterns of resort, points of conflict or collaboration, and shifts in health-seeking behaviour over time. A multi-sited ethnographic study was conducted in rural and urban Kenyan settings. Data were collected via prolonged participant observation, in-depth interviews with women of reproductive age, traditional birth attendants, herbalists, and biomedical practitioners, and analysis of local documents. Findings reveal a persistent and nuanced medical pluralism. A prominent theme was the widespread concurrent use of multiple systems, with most interviewees reporting use of traditional remedies alongside biomedical antenatal care. Decision-making was influenced by perceived efficacy for specific ailments, cost, and familial or community advice. Pluralism remains a fundamental and dynamic feature of Kenya’s healthcare landscape for obstetrics and gynaecology. The systems are not mutually exclusive but are frequently engaged in a complex, simultaneous manner by women seeking care. Policymakers and clinicians should formally acknowledge this reality. Initiatives to foster structured dialogue and referral pathways between biomedical and traditional practitioners are recommended. Public health messaging should address the reasons for pluralistic health-seeking behaviour. Medical pluralism, ethnography, maternal health, traditional medicine, Kenya, healthcare-seeking behaviour This study provides a contemporary comparative analysis of medical pluralism in Kenya, offering evidence of its enduring role in women’s health. It contributes a nuanced perspective for developing more integrated and responsive maternal health policies.