Cultural and Practical Barriers to Epilepsy Care in Uganda (2017-2018)

Epilepsy is one of the most common neurological disorders in world, affecting over 50 million people. While it is highly treatable, three of four people in low-resource countries do not get care.

There is significant misinformation and stigma about epilepsy in Uganda, with almost one in five people believing it is contagious. Less than a third of people know how to respond to a person having seizures. Supernatural or spiritual attributions for illness and the use of traditional healers employing herbal or spiritual interventions also exert influence on care seeking and provision.

Within the framework of Duke’s Division of Global Neurosurgery and Neuroscience (DGNN), this project team examined how to identify, quantify, predict and address the barriers to epilepsy care in Uganda. The team conducted a multi-method study that included interviews and focus groups with four stakeholder groups: patients and families, neurologists and psychiatrists, pastoral healers and traditional healers. The team transcribed, coded and analyzed these interviews, and, using a thematic analysis, found significant barriers to epilepsy care, ranging from social stigma to lack of medical infrastructure and medicine.

In order to address these barriers, the team designed interventions that include collaboration between biomedical healthcare providers and traditional healers, awareness building and the development of additional medical infrastructure to address medication stockouts. The 2018-19 team will expand on this work.

Timing

Summer 2017 – Spring 2018

Team Outcomes

Barriers to Biomedical Care, Beliefs about Epilepsy, and Care Seeking in Uganda: A Quantitative Approach (Deborah Koltai Attix, Payal Chakraborty, Nadine Sanchez, Alex Gualtieri, Drishti Sinha, Sam Bobholz, Erica Onuoha, Joao Vissoci, Mark Kaddumukassa, Kajumba Mayanja, Tony Fuller, Juma Kalyegira, Michael Haglund), presented at Bass Connections Showcase, April 18, 2018

Understanding the Barriers and Potential Solutions to Epilepsy Care in Uganda: A Qualitative Study (Nadine Sanchez, Deborah Koltai Attix, Kajumba Mayanja, Alex Gualtieri, Payal Chakraborty, Drishti Sinha, Juma Kalyegira, Erica Onuoha, Sam Bobholz, Michael Haglund), presented at Bass Connections Showcase, April 18, 2018

Elucidating Delay to Biomedical Care for Epilepsy Patients in Uganda: Traditional Healers as the First Line of Care (poster by Deborah Attix, Kajumba Mayanja, Nadine Sanchez, Alex Gualtieri, Payal Chakraborty, Drishti Sinha, Juma Kalygira, Sam Bobholz, Erica Onuoha, Diana Waters, Sandra Batakana, Michael Haglund), presented at Global Health Research Showcase, November 1, 2017

Addressing Cultural and Practical Barriers to Epilepsy Care in Uganda: A Mixed Methods Study (poster by Nadine Sanchez), presented at Global Health Research Showcase, November 1, 2017

Characterizing Epilepsy Treatment and Patient Outcomes in Uganda: A Hospital-based Prospective Cohort Study (poster by Payal Chakraborty), presented at Global Health Research Showcase, November 1, 2017

Reflections

Erica Onuoha

This Team in the News

DGHI Professor to Establish Uganda Epilepsy Centers of Excellence

See related team Cultural and Practical Barriers to Epilepsy Care in Uganda (2018-2019).

Bass Connections team members with their team's poster

/faculty/staff Team Members

  • Deborah Attix, School of Medicine-Medicine: Neurology;Psychiatry and Behavioral Sciences*
  • Michael Haglund, Duke Global Health Institute|School of Medicine-Surgery: Neurosurgery*
  • Joao Vissoci, School of Medicine-Surgery: Emergency Medicine

/graduate Team Members

  • Payal Chakraborty, Global Health - MS
  • Tony Fuller, Medicine-MD
  • Nadine Sanchez, Global Health - MS

/undergraduate Team Members

  • Erica Onuoha, Biology (BS)
  • Drishti Sinha, Neuroscience (AB)

/zcommunity Team Members

  • Mark Kaddumukasa, Department of Medicine, Makerere University
  • Martin Kaddumukasa, Department of Medicine, Makerere University
  • Kajumba Mayanja, Department of Psychology, Makerere University

Theme(s):