Discovering the Current Wound Management Practices of Rural Africans: a Pilot Study
Benskin, Linda 1959-
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Unrelenting heat, poor sanitation, lack of knowledge, and poverty contribute to a disabling wound prevalence that often exceeds 20% in rural areas of tropical developing countries. Wounds in this environment are usually poorly managed at very high cost. Traditional health practitioners and village health workers, rather than health professionals, provide health care in most villages. Wound management education for these nonprofessional health providers should include only sustainable practices which prove to be safe and effective in tropical villages. However, usual practice data, needed for comparison studies, is absent from the published literature. This pilot study introduced an innovative data collection method to overcome cultural obstacles which have prevented researchers from obtaining meaningful quantitative data in this challenging setting. Between August and October of 2012, seventy-five participants from 25 diverse villages in Ghana provided detailed descriptions of their current usual topical wound management methods by completing the stories of patients representing each of seven wound types commonly found in this setting. Responses were tabulated and categorized as congruent or not congruent with modern topical wound management principles within three domains and six subcategories (two for each domain). Four research questions organized the data analysis. The wound management practices of nonprofessional health care providers were identified and described in detail for the first time. These results are foundational to the process of developing culturally and environmentally appropriate wound management protocols for indigenous wound care providers in rural areas of tropical developing countries. In addition, several significant differences in the wound management of the three nonprofessional provider groups were found. The unique data collection method introduced in this study can easily be adapted to rural areas of other tropical developing countries. When sufficient data have been accumulated, the information can be utilized to design comparison studies so that the ecological validity of the wound management protocols in planned educational programs can be ensured.