Knowledge and attitude about the practice of traditional bone setters and its use for musculoskeletal disorders in rural areas in Nigeria

Abstract

Background: Vacillation between conventional healthcare professionals and traditional bone setters (TBS) for musculoskeletal (MSK) disorders is still common despite shortcomings and complications associated with TBS services. Objectives: This study assessed knowledge and attitude about the practice of TBS and its use for MSK disorders among Nigerian rural dwellers. Methods: This cross-sectional study utilized a multistage sampling method based on the World Health Organization procedures for a community-based survey to recruit 398 (213 males and 185 females) respondents from two randomly selected rural communities. A validated questionnaire adapted from relevant previous studies was used as a tool in this study. A household was served as the Primary Sampling Unit (PSU) and 60 PSUs were randomly selected. Results: The lifetime and 12-month prevalence of MSK disorders were 27.6% and 25.6%, respectively. Based on 12-month prevalence, neck (16, 21.6%) and shoulder (12, 17.6%) were the most affected body parts. The lifetime (i.e. “ever use”) and point (“current use”) prevalence of treatment by TBS were 19.3% and 3.8%, respectively. Among those who had ever experienced MSK disorders, 13.3% had experienced only treatment by TBS services, whereas 6.0% had used both treatment by TBS and orthodox medicine. Common services received by TBS were massage (61.0%), splinting (14.3%), traction (11.7%), and scarification (10.4%). Cost-effectiveness (42.9%), distance/accessibility (35.1%), and cultural beliefs (15.9%) were the major reasons for TBS patronage. Using TBS services was not significantly associated with socio-demographic variables (P > 0.05). Also, 57.3% of the respondents acknowledged that TBS services were associated with complications, such as gangrene (19.7%), malunion/nonunion of fractures (36.0%), paralysis (19.3%), joint instability (7.5%), and chronic osteomyelitis (6.6%). Users of the TBS services believed that they were effective in maintaining a healthy life (40.7%), with fewer side effects (30.0%), more effective (11.7%), and healthier than orthodox medicine (23.1%). Conclusions: There was a positive attitude towards treatment by TBS for MSK disorders, despite the complications and shortcomings that arise from the practice. Cost-effectiveness, socio-cultural beliefs, and easy access have increased patronage of treatment by TBS regardless of the socio-demographic characteristics of the people.