187408 Addressing Unmet Maternal Mental Health Needs?: Traditional Healers in Rural Haiti

Wednesday, October 29, 2008: 8:30 AM

Maria Small, MD, MPH , Obstetrics and Gynecology, Maternal Fetal Medicine, Duke University, Durham, NC
Rikerdy Frederic, MD, MPH , Hopital Albert Schweitzer, Port au Prince, Haiti
Gabriel Joseph, MD, MSc , Department of Health Administration and Public Health, Universite de Montreal, Montreal, QC, Canada
Trace Kershaw, PhD , School of Public Health, Yale University, New Haven, CT

In areas with limited resources to address maternal mental health and strong traditional spiritual beliefs around illnesses, women with special needs may preferentially seek the help of traditional healers for their care. At the time of the study, the hospital did not have a mental health care service provider.


We performed a cross sectional, community-based study of pregnant women presenting to antenatal clinics and assessed emotional, physical, and sexual abuse, measures of relationship power, socioeconomic status, stress and respondents' utilization of traditional medicine.


Of 197 study participants, 13% reported visiting a traditional healer in the past 6 months. The following had bivariate relationships with visiting a traditional healer:

• Stress concerning taking care of the baby (r=.16, p=.02)

• Symptom distress of vaginal discharge (r=.13, p=.08)

• Symptom distress of headaches (r=.15, p=.01)

• Less prenatal care visits (r=-.21, p=.003)

All correlations p<.10 were included in a multivariate logistic regression controlling for age, gestational age, and parity. Multivariate results showed that maternal age, gestational age, and parity accounted for 26% of the variance of visiting a traditional healer. (Chi-sq=29.84, p<.001). Unique significant predictors included: emotional abuse in the past 6 months (OR=2.59, 95% CI=1.01-6.68, p=.049), stress concerning taking care of the baby (OR=1.48, 95% CI=1.04-2.11, p=.031), and less prenatal care visits (OR=.63, 95% CI=.42-.93, p=.021


Women with fewer prenatal visits, more stress, and history of emotional abuse were more likely to seek the care of traditional healers. In settings of increased maternal stress and emotional abuse, traditional healers may serve as a source of support for women with few medical options. These relationships warrant further exploration and evaluation in both the Haitian context and globally.

Learning Objectives:
1. Address the role of Traditional Healers in Maternal Health, with focus on maternal mental health 2. Address integration of Traditional and Western Trained Healers in women's health in rural Haiti 3. Address role of Traditional Healers in domestic violence

Keywords: Underserved Populations, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Have extensive experience, both clinically and as investigator, working in rural Haiti.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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