Project
Integrative health systems for the management of cutaneous leishmaniasis in Suriname
Cutaneous leishmaniasis (CL) is a parasitic, neglected tropical disease with a high burden of disease. In low- and middle-income countries, CL patients lack access to medical treatment due to various obstacles. To improve access to care, it may be beneficial for CL-patients to receive options for integrative healthcare with traditional medicines. We aim to gain insight into how conventional- and traditional indigenous health systems can be integrated to improve disease management of CL among remote communities in Suriname. We will apply systems perspective and mixed-methods to study current- and desired health systems, assessing various aspects of ‘access to care’.
Background
Cutaneous leishmaniasis (CL) is a parasitic, neglected tropical disease with a high burden of disease. In many low- and middle-income countries, CL patients lack access to medical treatment due to many obstacles. There are reports of CL patients tending to self-medication or who seek services from traditional healers in the Amazon rainforest in South America, including in the Republic of Suriname. To improve access to healthcare and to improve CL disease management, it may be beneficial for CL patients to receive integrative healthcare through conventional- and traditional medicine.
Description
This project assesses whether integrative conventional- and traditional health systems can improve access to treatment, and management of CL among indigenous populations in the Amazone of Suriname. This study will be conducted in various remote areas in Suriname, in particular the remote Trio-indigenous village Kwamalasamutu in the South-western part of Suriname. The Trio peoples are indigenous to the Amazon and possess traditional knowledge, including traditional medicine against CL. Suriname is the smallest country in South America and the most forested country in the world, famous for its diverse cultures and home to a high variety of indigenous peoples who make up around 5% of the total population.
To guide the research process, a systems perspective will be used to address complexity of real-world contexts, to understand the elements of the health system, the interactions between the elements and multiple levels and how change might occur. We use the Action Scale Model (ASM) as this model conceptualizes, identifies and appraises actions within complex (health) systems, and identify changing points to improve CL management.
We will use mixed-methods to study current and desired health systems with ‘access to care’ to improve the management of CL. Various methodological approaches will be applied, e.g., a systematic literature review, case study, interviews, stakeholder meetings, and focus groups. We stimulate active participation of stakeholders, including CL patients, traditional healers, Suriname Medical Mission, NGOs, government representatives and Dermatological Services in Suriname.