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      Exploring the preferences of traditional versus Western medicine in the Spiti Valley region of India: A qualitative approach

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          Abstract

          Background

          Traditional healing practices are prevalent in rural and mountainous areas of India where Western medicine is not accessible. WHO guidelines recommend integration of traditional and Western medicine to meet rural primary care needs. We explored three dimensions of rural patients' decision-making and satisfaction with their medical care: pregnancy-related concerns, pediatric care for children under five, and acute injuries.

          Methods

          We conducted a qualitative study using a phenomenological approach in India's Spiti Valley between August and October 2023. Sixteen individuals, age 18 years and older, participated in one-on-one interviews. The interviews were transcribed from Hindi into English, reviewed for accuracy by a native speaker, and imported into Dedoose software. Data were analyzed using inductive coding.

          Findings

          Multiparous women aged 35–44 were concerned about pregnancy complications, leading them to choose Western medicine despite access and cost barriers. Pediatric illness requiring urgent care at night was a concern for women with children under five. Those in the injuries group reported having to travel for care beyond basic first aid. Overall, concerns were about limited access to some services locally, as well as costs of travel, medical procedures, and medications when services were obtained beyond the local area.

          Interpretation

          All participants considered their traditional healer their first point of contact for medical care. A number of Western medical services were not available locally. These findings suggest a need to strengthen access to and integration of Western and traditional medical care in rural settings in India.

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          Most cited references23

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          Code Saturation Versus Meaning Saturation: How Many Interviews Are Enough?

          Saturation is a core guiding principle to determine sample sizes in qualitative research, yet little methodological research exists on parameters that influence saturation. Our study compared two approaches to assessing saturation: code saturation and meaning saturation. We examined sample sizes needed to reach saturation in each approach, what saturation meant, and how to assess saturation. Examining 25 in-depth interviews, we found that code saturation was reached at nine interviews, whereby the range of thematic issues was identified. However, 16 to 24 interviews were needed to reach meaning saturation where we developed a richly textured understanding of issues. Thus, code saturation may indicate when researchers have "heard it all," but meaning saturation is needed to "understand it all." We used our results to develop parameters that influence saturation, which may be used to estimate sample sizes for qualitative research proposals or to document in publications the grounds on which saturation was achieved.
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            Directed qualitative content analysis: the description and elaboration of its underpinning methods and data analysis process

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              Health systems in India

              Health systems and polices have a critical role in determining the manner in which health services are delivered, utilized and affect health outcomes. ‘Health' being a state subject, despite the issuance of the guidelines by the central government, the final prerogative on implementation of the initiatives on newborn care lies with the states. This article briefly describes the public health structure in the country and traces the evolution of the major health programs and initiatives with a particular focus on newborn health.
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                Author and article information

                Contributors
                Journal
                Dialogues Health
                Dialogues Health
                Dialogues in Health
                Elsevier
                2772-6533
                17 June 2024
                December 2024
                17 June 2024
                : 5
                : 100185
                Affiliations
                [a ]University of Utah, Department of Family & Preventive Medicine, Division of Public Health, 375 Chipeta Way A, Salt Lake City, UT 84108, United States of America
                [b ]University of Utah, College of Social Work, 395 1500 East, Salt Lake City, UT 84112, United States of America
                Author notes
                [* ]Corresponding author at: The Uiversity of Utah, Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Way Suite A, Salt Lake City, UT 84108, United States of America. u1324186@ 123456utah.edu aaguzzi1@ 123456jhu.edu
                Article
                S2772-6533(24)00021-2 100185
                10.1016/j.dialog.2024.100185
                11253261
                39021532
                7be8b9df-4b59-4526-a0a0-d534c05edc02
                © 2024 The Authors. Published by Elsevier Inc. CC BY-NC-ND 4.0.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 5 February 2024
                : 28 May 2024
                : 15 June 2024
                Categories
                Good Health and Well-being

                health policy,primary care,prenatal care,labor & delivery,pediatric care,acute illness & injuries,traditional medicine,western medicine india,integrative medicine,ayush-based medicine,access to healthcare,health disparities,qualitative research,qualitative approach

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