View from Ghana: Why integrating TCIM with primary health care services is key

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

What has been Ghana’s experience in TCIM development?

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

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

Since 2017, we have started pilot tests to integrate TCIM as part of primary health service delivery in the public health sector. We now have 55 TCIM services integrated into public health facilities. But we must do much more. Not only in Ghana but also in the entire African region, we need to identify gaps and build bridges between traditional and conventional medicine, to work together.

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

With the implementation of 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 have estimated that there are at least 40,000 practitioners of various TCIM practices in Ghana. At MOH, we have registered up to 10,000. This means we have a lot of work to do, not only in Ghana, but in all our countries.

TCIM practices are at the center of communities; people go to them because they know them, they speak their languages, they know their customs and traditions. In many settings, TCIM professionals provide essential primary health care. In the past, they used to operate mainly in the private sector, so even educating them about safety regulations and standards takes a lot of effort. This also means that 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 TCIM delivery?

It is very necessary to build bridges between communities. We invite many traditional medicine researchers and practitioners to events such as the African Traditional Medicine Day 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 work together to help people be healthier.

Equally, it is essential to integrate service delivery centered on patient-centred care. We need to promote referral services; for TCIM professionals to say, for example, if the patient needs urgent attention from conventional medicine, say, has high blood pressure or symptoms of infectious diseases, to refer to the necessary care in medical clinics conventional because the patient does not lack the necessary early diagnosis and care. At the same time, conventional medicine providers can refer to MIC care if the patient expresses interest in accessing MIC interventions and can benefit from them. This type of collaboration and integration can help provide truly holistic care for people to achieve better health and wellness.

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