Perceptions of Collaboration between Traditional Bone Setters and Formal Care Providers in Cameroon: Bridging Gaps in Injury Care.

Introduction

In Cameroon, there are not enough formal care (FC) providers to treat the high volume of injured patients. Traditional bone setters (TBS) offer widely patronized alternatives for injury treatment; however, the integration of TBS into the healthcare system remains limited. Collaboration between TBS and FC providers could expand the reach and effectiveness of injury care. We explore perceptions of Cameroonian TBS and FC providers regarding injury care and willingness to collaborate. Methodology: We used snowball sampling to survey TBS and FC providers in two regions of Cameroon. Structured questionnaires were used to assess FC and TBS providers' beliefs regarding potential collaboration. Categorical variables were analyzed with the chi-squared test while Likert scale responses were analyzed with the Kruskal-Wallis test.

Results

We surveyed 120 providers (n=58 TBS, n=62 FC). TBS providers were significantly older (TBS median age 51, IQR 39-60 years vs. FC 34, IQR 30-36 years; P<0.001), greater percentage male (TBS 72.4% vs. FC 51.6%, P=0.019), and had more years of practice experience (TBS median 20, IQR 11-28 years vs. FC 5, IQR 3-8 years; P<0.001). While the majority of TBS (93%) and FC providers (77%) indicated willingness to collaborate, they disagreed regarding specific roles. Though the TBS providers believed they could conduct post-operative follow-up care, FC providers disagreed (TBS median response "Agree" vs. FC "Disagree," P<0.001). FC providers also did not believe TBS could provide appropriate injury care triage (TBS "Agree" vs. FC "Neutral," P<0.001). TBS and FC providers agreed that TBS could rehabilitate injured patients, although TBS agreed more strongly (P<0.001).

Conclusions

The study demonstrates the willingness of both FC and TBS providers in Cameroon to collaborate in injury care, particularly in rehabilitation services. However, the cohorts disagree regarding the specific roles of TBS providers in injury triage and post-operative follow-up care.