African and Western Indigenous Knowledge Systems - Relevance to HIS

By Zufan Abera

Oct, 2013

"African and Western Indigenous Knowledge Systems - Relevance to HIS"

• African indigenous knowledge system….Ok

• Western indigenous knowledge system?

Outline

Indigenous Knowledge systems Combining the Indigenous and Scientific

knowledge systems Health Information Systems Using Indigenous Knowledge for HIS Conclusion

Indigenous Knowledge Systems“A systematic body of knowledge acquired by local people through the accumulation of experiences,

informal experiments and intimate understanding of the environment

in a given culture” (Rajasakeran et al., 1992).

Outsiders mostly recognize certain aspects of the indigenous people.

• Source- http://www.ankn.uaf.edu/IKS/Iceberg.html

Indigenous knowledge Systems Cont.

This knowledge system includes wholeness, community and harmony which are deeply embedded in cultural values (Mkabela 2005)

Indigenous people have traditionally acquired their knowledge through direct experience in the natural world. “Learning by doing”

Indigenous knowledge systems are constantly adapting and changing in response to new conditions.

This knowledge domain is an under-utilized resource for development, and mainstreaming is critical.

Indigenous knowledge Systems Cont.:-Differences between the two Knowledge

Domains

(Source.- Rahman, 2000:5)The common ground, include the knowledge is stable, but subject to modification, offer skill and procedure to do and way of doing.

Indigenous knowledge

Scientific knowledge

Tacit knowledge (Subjective)

Explicit knowledge (Objective)

Knowledge of experience (body)

Knowledge of rationality (mind)

Traditional knowledge Modern KnowledgeAnalog knowledge

(practice)Digital knowledge

(theory)Holistic Compartmental

Indigenous Knowledge System:- Role for Different Fields

Agriculture Animal husbandry and veterinary medicine Use and management of natural resources, and biological diversity

Conflict resolution.- Indigenous knowledge the gives basis for grassroots decision-

making, The role of elders and local judges

Saving and lending Through indigenous organizations and associations, problems are

identified, and solutions are determined.

Preventive medicine and psychosocial care

Indigenous Knowledge for Health:-Different Types of Healing Practices

Indigenous Knowledge for Health Cont.

The Nigerian indigenous post-partum care for the mother and the newborn

The indigenous community-based institutions:- for example, “Eders” in Ethiopia have the potential of Traditional Social Insurance for Supporting Health Care (Mammo, 1993, Mengesha, 2011).

Alternative medicine in Kenya has remained popular because of its accessibility, affordability and efficacy despite vilification through governmental policies (Falola and Heaton, 2008).

There is a need “ to build on local cultural realities, strengthen

existing community resources and develop social capital for

sustainable development”.

Indigenous Knowledge for Health Cont.:- Harmful practices

There are harmful practices originated from the indigenous knowledge, examples, cutting uvula of small children, female genital mutilation, etc.

Not all herbal medicines have good effects, Some traditional medicines and practices are blamed as

causing certain complications and deaths (Stewart 2001).

Some traditional healers may give «uncertain promises» in relation to treating some diseases.

African Indigenous Knowledge System

The acquisition of knowledge is collective and community oriented. African knowledge system to be represented in the form of sculpture,

wooden carvings, rock paintings, structured cultural institutions, etc. Its rich complexities are found in the community ceremonies and

rituals: such as, story-telling, proverbs, folktales, poetry, reasoning, praise, songs, puzzles, etc.

• Afro-centric approach encourages cultural and social immersion:- indigenous peoples are active participants in the articulation of the views, concerns and research questions that they deem important to their cultural context.

African Indigenous Knowledge System Cont.

African knowledge is vulnerable because many of the carriers of this knowledge are dying without the documentation of these knowledges.

To preserve such knowledge, a new path must be charted; for example participatory video can be used as a means of collecting and disseminating indigenous knowledge

”In Africa, when an old person dies it is like when a library burns down” Amadou Hampâté Bâ, Malian philosoper

Western Indigenous Knowledge System

The basic component of any country’s knowledge system is its indigenous knowledge. It encompasses the skills, experiences and insights of people, applied to maintain or improve their livelihood.

The indigenous people in Western countries also have their unique way of living style,

Example, the Alaska people in Northern America:- the knowledge base that Alaska Natives have acquired through cumulative experience over millennia.

Aboriginal Australians. Sami People:-

The Sami people live in four European

countries Traditional face paint to an Aboriginal boy

Western Knowledge System Cont.

Western knowledge system often is portrayed as superior, universal, and as not having the ‘‘cultural fingerprints’’ that appear to be much more noticeable in other knowledge systems (Gough 1998: 508).

The representation of “Western science” is used as criteria for declaring ‘‘other’’ knowledges as non-science.

All knowledge forms need to be treated equally

Combining the Indigenous and Scientific knowledge systems

There is no seamless combination of the two knowledge systems

The three frequently mentioned reasons

1. The incommensurability of the two types of knowledge systems,

The two knowledge systems have their own way of knowing The indigenous knowledge regarded as primitive, simple and

static; Not amenable to systematic scientific investigation.

2. The underlying political and power dimensions of the participants or stakeholders involved (Nadasdy, 1999:2).

Combining the Indigenous and Scientific Knowledge Systems:- the Power Imbalance

Many beneficial local practices disappear only because of the intrusion of foreign technologies or development concepts

The local environmental knowledge of the rural community in Ethiopia was discredited because they were held responsible for producing environmental degradation (Hoben, 1995).

Higher yielding sorghum varieties were introduced in Ethiopia to increase food security, but faced sustainability problem (Oduol, W. 1992)…

Combining the Indigenous and Scientific Knowledge Systems Cont:- Conflict of Interests

3. The competing underlying interests

Who should benefit from the discovery of the new drug?

The Traditional healer

The Scientist

The Community

Creating Knowledge Alliance

However, understanding knowledge production as performance enables seemingly disparate knowledges to work together so as to produce new knowledge spaces, Turnbull (1997: 560).

Examples Establish a continuum between scientific and the community weather

forecast (Rengalakshmi, 2006) Combining of technical knowledge, scientific knowledge and

indigenous community knowledge for GIS in India (Puri, 2003, 2007) Knowledge alliance from community and scientific sources for health

service provision and HIS (Damtew and Aanestad, 2012)

Health Information Systems

Health information systems are the foundations for public health (AbouZahr and Boerma, 2005).

Why Health Information Systems

There is a need by the health sector of developing countries to use the limited resource effectively

This requires sound management that is based on information

Measuring the health status of the population, and design intervention programs

Information is required to evaluate national and international efforts, example, the Millennium Development Goals.

Evaluate effectiveness /efficiency of health services given to population

Health Information Systems in Developing Countries

Collect every possible data (For example Braa et al.,2007; Mengsitie, 2010)

Be vertically designed: where Data/info exclusively flowing upwards

Focus on international and national requirements rather than local demands

Have data of poor quality Used little for decision making activities Duplication and waste among parallel health information

systems: Health Care measurement in developing countries has been

dominated by fragmented donor-driven efforts (Chilundo, 2005).

Health Information Systems in Developing Countries Cont.

Several registers used by health workers for registering similar information

Duplication of efforts. Share health workers time

Enormous investment has gone into computerized health information systems

Health data compiled using computer

Health Information Systems in Developing Countries Cont.

Strong belief that Health information system=TechnologyMostly, the introduction of IT in developing countries entails through donors’ initiatives There is minimal user participation from the inception of ideas of such systems, their initiation, design, development and implementation

HIS systems in developing country mostly fail

Health Information Systems in Developing Countries Cont.

The HIS failure can be a total failure or Partial failure (Heeks, 2002)

The “sustainability failure” of an initiative that succeeds initially is common in developing countries.

The domain of developing country information systems is particularly dominated by the transfer of Northern designs to Southern realities.

Health Information Systems in Developing Countries Cont.

When knowledge and technology are imported, the systems in which they were operating in the country of origin also gets reflected…this dependency on outside initiatives has resulted in the weakening of the survival strategies of African communities (Zegeye and Vambe, 2006).

Design is always design from somewhere (van der Velden, 2013).

Hence the methods and concepts for the system design must be shaped by local practices and conceptualization (Bidwell, et al., 2013)

Indigenous Knowledge for HIS

How the indigenous knowledge benefit the Health Information Systems of Africa?

Indigenous Knowledge for HIS

The health information systems – incorporate not just technological but also social and organizational factors

People

Procedure

Culture (Values,

Norms, tradition, etc)

Processes  

Behavioural Sub-system

Interaction

Technological Sub-system

Hardware

Software

Network

Data

Impediments to Use Indigenous Knowledge for HIS

Policy-Practice gap: example banning of TBAs not to offer delivery service in Malawi (Kanjo, 2012).

Training of health workers and the community using the western methodology:

Over-relying on technology Minimal involvement of the peripheral level staff, and the community

in the design and implementation of HIS HIS require documentation; but most indigenous people (knowers) do

not write and read Loose feedback mechanism Shortage of Resources

Using Indigenous Knowledge for HIS:- Problems and Possible Solutions

Consider the reality for Policy and HIS designProblems Possible solutions

Policy- practice Gap

Consider the realities at the ground

Use local input in the process of policy formulation

Over-relying

on technology

Consider the Social-cultural factors,

Constantly renegotiating and collaboration between external designers, users and the community

Using Indigenous Knowledge for HIS:- Problems and Possible Solutions Cont.

Adjust training programs to local realitiesProblems Possible solutions

Training of health workers and the community using the western methodology:

Offer Trainings to the community using the community dialogue, rituals and practices

Example: training of TBAs about the importance of registering the delivery service through traditional song and dance (experience from Malawi)

Using Indigenous Knowledge for HIS:- Problems and Possible Solutions Cont.

Community health information systemsProblems Possible solutions

Minimal involvement of the community for their own health issues.

Nurturing the community health information systems

Using Indigenous Knowledge for HIS:- Problems and Possible Solutions Cont.

Documenting M-CH data by TBAProblems Possible solutions

HIS require documentation; but most indigenous people (knowers) do not write and read

Improvisation and use the available materials, and other opportunities that help for documentation

Registering by the local

midwife by adding small stones in a five-part box (Experience from Sierra Leone).

Using Indigenous Knowledge for HIS Cont. Strengthen the feedback mechanism

Problems Possible solutions No or very little feedback

mechanism (The reports flow up-ward)

Inform the community about their own health status and achievements

Use prior knowledge as a foundation to build on and teach new concepts – the constructivist way of learning (experience from South-Africa).

Use indigenous community-based institutions for strengthening collaboration for health

Shortage of Resources

Strengthen the HIS and use the available resources effectively

Develop community ownership, and use the community potential for health and HIS

Summary

Indigenous

knowledge system

Combining the two knowledge system

Improve Public health

Evidence-based decision making

Sustainable HIS

Scientific knowledge

Technology, standards

Local solutions and alternatives

Conclusion

Indigenous knowledge is not yet fully utilized in the development process.The importance of indigenous knowledge is acknowledged to enhance sustainable development endeavors Sound health information systems are essential to make evidence-based decision making There is no universal knowledge.Establishing knowledge alliance between the indigenous and scientific sources is required for the betterment of HIS

References

Byrne, E., Sahay, S. (2007). Participatory Design for Social Development: A South African Case Study on Community- Based Health Information Systems. Information Technology for Development, 13 (1) 71–94.

Damtew, Z., Aanestad, M. (2012). Benefits of Local Knowledge in Shaping Standards:-A Case Study from Community Health Service and Information Systems in Ethiopia. Scandinavian Journal Information Systems. 24 (2), 27-50.

Hoben, A. (1995). Paradigms and politics: the cultural construction of environmental policy in Ethiopia. World Development, 23 (6): 1007-1021.

Kanjo, C., (2012). In Search of the Missing Data: A case from Maternal and Child Health Data in Malawi. Faculty of Mathematics and Natural Sciences, University of Oslo.

Puri, S. (2007). Integrating scientific with indigenous knowledge: Constructing knowledge alliances for land management in India. MIS Quarterly, 31 (2): 355-379.

Rajasekaran, B., Warren, D.M. and S.C. Babu (1991). Indigenous natural-resource management systems for sustainable agricultural development – A global perspective. Journal of International Development, 3 (1): 1-15.

Turnbull, D. (2000). Masons, Tricksters and Cartographers: Comparative Studies in the Sociology of Scientific and Indigenous Knowledge. Amsterdam, Harwood Academic Publisher

Thank You