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Background: A significant number of women experience labour without effective pain management and thus suffer from unbearable labour pain to the extent they term labour as the most agonizing event in their lives. Unresolved labour pain can lead to stress, fear, and confusion, which may compromise placental perfusion and lead to birth asphyxia. Although various pharmacological and non-pharmacological labour pain management methods exist, the use of non-pharmacological methods (NPMs) to manage labour pain has remained low in low-resource settings. This paper explored the barriers for using NPMs to manage labour pain by nurse-midwives in eastern Tanzania. Methods: We conducted an exploratory qualitative study with 18 nurse-midwives purposefully recruited from the labour wards of two selected district hospitals in eastern Tanzania. Qualitative content analysis guided the data analysis. Results: Two categories illustrating barriers to using NPMs were generated: individual-level and institutional-level barriers. Individual-level barriers include (i) limited competencies of nurse-midwives on the use of NPMs for managing labour pain, (ii) inadequate exposure to labour pain management practices, (iii) misconceptions about labour pain relief, and (iv) a lack of opportunities for knowledge acquisition. The institutional barriers include (i) a critical staff shortage amidst many clients and (ii) an unfavourable healthcare facility environment. Conclusion: The implementation of NPMs for labour pain management by nurse-midwives in eastern Tanzania faces several institutional and individual barriers. We recommend addressing both supply- and demand-side barriers. Strengthening nurse midwives' competencies in NPMs adoption and use and improving the facility environment to ensure privacy during labour can be a starting point for addressing supply-side issues. We recommend dispelling myths and misconceptions through health promotion education to address demand-side barriers. [ABSTRACT FROM AUTHOR]

Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics). The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General findings suggest that initiating collaboration is not as easy as it appears to be from the literature, if it is to be meaningful; and thus we are calling for appropriate strategies to access potential healers targeted for any study designed with sustainability in mind. [ABSTRACT FROM AUTHOR]

Hospital practitioners in East Africa see traditional and modern medicine interrupt and interfere with one another on hospital grounds everyday. In response, nurses and nurse's aides have developed innovative ways of assembling diverse therapies and the knowledges, practices, desires, and medicines of which they consist. Through their care and coordination, nurses and nurse's aides forge complex bodies within the therapeutic interruptions and interferences they face in their clinical work. [ traditional medicine, biomedicine, body, ontology, Tanzania, Africa] [ABSTRACT FROM AUTHOR]

This article explores how 'modern traditional' healers, working in Kyela District in the south west of Tanzania, attempt to challenge and transcend a widely-recognised dualism that places forms of biomedicine as 'modern' and all varieties of indigenous healing as 'traditional'. Drawing on the notion of 'intentional hybridity', the article analyses conversations with healers, which reveal how their practices and aspirations operate to destabilise the boundaries that are so essential to the way that they and their medicines are imagined. Framing their practices in terms of competition for business between both mission medicine and government-employed biomedical practitioners, the healers worked to reposition themselves within this 'modern' and moral space by emphasising the similarities between their own medicines and biomedical pharmaceuticals, for instance, or claiming that biomedical personnel are jealous of their ability to attract patients (or customers). They were also prepared to support a local government initiative that, if effective, may reduce the incidence of witchcraft-related illness - a stance which in theory does not make good 'business sense', yet that places them firmly in opposition to some forms of 'tradition'. Finally, the article details the technical innovations which healers would like to appropriate from biomedicine. In conclusion, the material presented demonstrates the ability of the healers to transcend, contest and make use of the constructed categories through which they are imagined in Tanzania. [ABSTRACT FROM AUTHOR]