Informal versus formal integration of traditional health care: The unique case of the Sadanga in Mountain Province, Philippines

Although health care has been devolved to the community level in the Philippines since 1991 and integration of traditional medicine into the formal health care system has been recognized since 1997, an informal integration of traditional medicine and biomedicine has existed in communities prior to both of these formal processes. This research compares the outcomes of both informal and formal integration of traditional medicine into health care systems on community health, as well as on the health care system itself.

1000 community members, administrators, and health care workers from five municipalities throughout the Philippines were non-randomly selected through snowball and convenience sampling for semi-structured interviews and focus groups using open-ended questions. Hospital and municipal morbidity and mortality records were utilized for quantitative data analysis. N-Vivo and SPSS was employed for data analysis.

Findings include a lower level of community satisfaction and health care outcomes in formalized top-down health care integration, than in either informal health care integration or formal bottom-up health care integration. Informal health care integration that occurred as a natural process within the community and was both respected and informally integrated by the local municipal health office was found to provide greater access to and higher satisfaction with the local health care system. Qualitative findings were substantiated via quantitative analysis of local morbidity and mortality records. The implications of these findings for local and global health care policy is explored.