Assumptions of global beneficence: Health-care disparity, the WHO and the outcomes of integrative health-care policy at local levels in the Philippines

Abstract

Traditional, complementary and alternative medicine (or heterodox health care) functions as the primary source of health care for a majority of populations in low-income countries. The World Health Organization has promoted the integration of heterodox health-care practices and practitioners into formal state and local biomedical health-care systems. Heretofore, the literature has assumed the beneficence of this policy in reducing health-care disparity, without assessing the outcomes of this policy’s implementation. This research examines the impact of health-care integration policy on local health care in communities in four municipalities in the Philippines. Communities in two municipalities that implemented health-care integration (top-down and bottom-up) were compared with two municipalities that did not implement health-care integration. A qualitative design of data collection was utilised. Convenience samples (n=500) of community members, community leaders, health-care providers and key policy actors participated in semi-structured interviews and focus groups to assess the changes in community health-care systems and in community health-care access following health-care integration. The assumptions of beneficence of health-care integration are not supported by this research. Furthermore, this research suggests that health-care integration may not be beneficial to communities if implemented in a manner that ignores the particular needs of a given local context.