Uncharted Paths: The Use of Traditional, Complementary and Alternative Medicine (TCAM) among Sub-Saharan Africans living in the Greater Toronto Area (GTA)

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Amegbor, Prince

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thesis

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eng

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Traditional, Complementary and Alternative Medicine (TCAM) , Sub-Saharan Africans , Immigrants , Greater Toronto Area , Translocational positionality , Mixed-methods , Ethnicity , Identity

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The appeal of traditional, complementary, and alternative medicine (TACM) is growing among persons living in developed countries. Personal beliefs and traditional values about health and healthcare are deemed significant motivations for the use of TCAM. While existing studies have focused on diverse population groups, including persons of European and Asian descent, TCAM use and behaviour among persons of sub-Saharan African (SSA) descent living in Canada and other developed countries remains unknown. Existing studies on TCAM and healthcare-seeking behaviour of racial or ethnic minorities suggests possible alienation due to sociocultural health beliefs and practices. These studies fail to investigate the role of context in the identity construction and sociocultural belonging and how this ultimately affects the choice of healing practices. Anthias' (2002, 2008, 2012a) asserts that immigrants and their descendants have complex relationships with different locales – country of residence (or naturalised countries) and country of origin. This complex relationship entails social, cultural, symbolic and material ties between homelands and destinations. This research seeks to examine TCAM use among persons of SSA origin living in the GTA and to understand how ethnocultural identity informs the use of TCAM remedies using Anthias’ translocational positionality as a theoretical framework. The study uses a sequential mixed-method approach to garner data on sociodemographic characteristics, transnational relationships, health status and health care-seeking behaviours of persons of SSA origin living in the Greater Toronto Area. Lifetime prevalence of TCAM use among respondents of SSA descent is ~57.14% and 12-month prevalence of TCAM use is ~23.81%. About 48.72% of the respondents indicated the TCAM used are of their ethnocultural origin. A sizeable proportion of respondents had unmet TCAM need (~20.88%) and engaged in transnational healthcare-seeking behaviour or medical return (~39.56%). The findings of the interview show the meaning associated with ethnocultural identity and the broader contextual factors that influence the utilisation of ethnocultural identity in health promotion or healthcare-seeking. The findings of the interviews challenge the alienation assumption and show the ability of participants to transcend and transition between ethnocultural identities in different contexts.

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