Cultural Mediators in Pluralistic Health Systems: A Mixed-Methods Exploration of Traditional Healers' Sexual and Reproductive Health Practices in Odisha's Tribal Districts

Abstract

Background: Traditional healers provide primary healthcare for 22.85% of Odisha's tribal population; however, evidence regarding their sexual and reproductive health (SRH) service provision is limited. This study explored the role of traditional healers as cultural mediators in pluralistic health systems.

Methods: A cross-sectional exploratory study of 32 traditional healers across four tribal districts (Mayurbhanj, Gajapati, Kandhamal, and Rayagada) was conducted from January to March 2024. Data collection employed structured questionnaires administered through face-to-face interviews to assess 16 SRH service variables. Statistical analysis using SPSS 26.0 included descriptive statistics and exploratory chi-square tests with Bonferroni correction (α=0.003).

Results: Traditional healers demonstrated selective SRH engagement: youth sexual health education support (84.4%, 95%CI: 68.2-93.1), STI treatment (78.1%, 95%CI: 61.2-89.0), but limited modern contraceptive awareness (31.3%, 95%CI: 18.0-48.6). District-level variations reveal specialized service patterns. Post-hoc power analysis indicated 35% statistical power, confirming the pilot study status.

Conclusions: This exploratory research provides preliminary evidence of traditional healers' adaptive roles in SRH service provision. The findings inform future large-scale studies and targeted integration strategies within Odisha's pluralistic health system.