Traditional versus orthodox fracture care in uyo, Nigeria

Background The general perception in Uyo, the capital city of Akwa-Ibom State, is that the populace prefers Traditional Bone Setter (TBS) care to Modern Orthopaedic Fracture care. Aims and Objectives Given the option, this study aims to ascertain the attitude of the population on choice between TBS and orthopaedic fracture care and identify some of the reasons for such a preference, thus providing a basis for improving orthodox care delivery and increasing patronage of same. Design of the study This is a prospective observational study, using self-administered pre-tested questionnaires. Setting The study was carried out in two sites - the General Out-patient Department of the University of Uyo Teaching Hospital (UUTH) and in the major town based public transport park in Uyo. Materials and Methods This study was carried out on two populations: one in the General Out-patient Department of the University of Uyo Teaching Hospital over a three-day period, and the other in the general Uyo community over a five-day period, using a self-administered pre-tested questionnaire. The required sample size was determined to be 24 for both populations, using the Statcalc domain of Epi-info 3.4.1. However, 95 respondents were recruited into the GOP arm and 150 into the Community group. Consent for the study was obtained from the Ethical Research Board of the Hospital. Results Sixty percent (60%) of our hospital clients will opt for hospital care if they sustain a fracture. In the community, 64% prefer TBS treatment for a fracture, while 36% prefer hospital care for the same problem. When both sets of data were combined 134 people (54.7%) preferred TBS care. There was a positive correlation between the preference for hospital care and the highest level of education that the person achieved. People in the community indicated that the fear of a limb amputation was their main reason for preferring TBS care, if they or a relation sustained a fracture. Conclusion This study shows a greater preference for TBS care in Uyo, due to the fear of amputation, the long time to see the doctor, a presumed high cost of orthodox care and a lack of formal education. Religious concerns and the duration of care are not important determinants. Reducing the waiting time for seeing a doctor and the immediate cost of orthopaedic care; improving the patient - doctor relationship and public enlightenment about the processes of medical care (especially to allay the fear of amputation), will help to improve the proportion of the Uyo populace, who access and benefit from Orthopaedic fracture care.