When Faith, Healers and Clinics Compete: How Ethiopians Choose Their Care

In the highland city of Debre Tabor in northwestern Ethiopia, a person who falls ill rarely faces a single path to recovery. They may visit a health center, consult a traditional healer, seek prayers at a church or mosque, or move through all of these options in sequence. A new qualitative study published in the International Journal for Equity in Health examines how residents of this city actually navigate that landscape, and its findings challenge the assumption that biomedical care and traditional healing exist as rivals. Instead, the research portrays health-seeking as a fluid, socially embedded process in which culture, religion, family networks and economic realities all shape the decisions people make about their bodies.

The study, conducted by Tinsae Ashagrie Dagnew of the Department of Sociology at Debre Tabor University, is based on semi-structured and key informant interviews with 27 participants. The group included ordinary community members, religious leaders, traditional healers, healthcare professionals and elders, giving the researcher access to multiple perspectives on how illness is understood and treated. The work was approved by the university’s Institutional Research Ethics Review Committee, and all participants gave informed consent. Data were analyzed thematically, and the analysis was guided by three established theoretical frameworks: Arthur Kleinman’s explanatory model of illness, medical pluralism theory, and Pierre Bourdieu’s theory of practice.

One of the study’s central findings is that illness itself is not interpreted in a single way. Residents understood sickness through physical, spiritual, social and divine frameworks simultaneously. A symptom might be seen as a biological malfunction, but it could also be read as a spiritual affliction, a rupture in social relations, or a test or punishment with divine origins. Because illness carries these layered meanings, treatment cannot be confined to one system. This interpretive plurality sustains reliance on traditional and faith-based healing even when biomedical services are available, and it explains why many patients move between modalities rather than choosing one exclusively.

The concept of medical pluralism, the coexistence of multiple healing systems within one society, is at the heart of the research. In Debre Tabor City, pluralism manifested in two characteristic patterns: sequential and complementary therapeutic practices. In sequential use, a patient tries one system after another, perhaps starting with a traditional remedy and turning to a clinic if the condition persists, or the reverse. In complementary use, different treatments are pursued at the same time, with prayers running alongside prescribed medication. This pattern was especially pronounced for chronic conditions, where prolonged suffering and uncertain outcomes encourage people to keep multiple therapeutic doors open.

Religion emerged as a powerful force in the study, but not merely as an alternative to medicine. Religious belief and practice provided psychological resilience and social support, helping individuals cope with the fear and uncertainty that accompany illness. Congregations and faith communities functioned as networks of care, offering prayer, encouragement and practical assistance. Religious leaders, as trusted figures, also influenced how people interpreted symptoms and which treatments they considered legitimate. This means that faith institutions are not peripheral to health in Debre Tabor; they are active participants in the therapeutic process, shaping both meaning and behavior.

Family and community networks proved equally decisive. Treatment decisions were rarely individual choices. Elders, relatives and neighbors weighed in on what an illness meant, which healer or facility should be consulted, and how much money should be spent. In a society where social standing and collective identity matter deeply, the opinions of trusted others can carry more weight than the advice of a clinician who may be a stranger. This finding aligns with Bourdieu’s theory of practice, which the study used to show how health decisions are shaped by habitus, the ingrained dispositions people acquire from their social environment, and by the forms of capital, economic, social and cultural, that they can mobilize.

Structural constraints added another layer to the picture. Economic limitations, geographic accessibility and perceived service quality all influenced healthcare choices. For households with limited income, the cost of transport, consultation fees and medications can make biomedical care feel out of reach, while traditional and religious options may appear cheaper or closer at hand. Where health facilities are perceived as crowded, impersonal or ineffective, confidence in them erodes, reinforcing preference for familiar community-based modalities. The study suggests that these constraints do not simply reflect individual preference; they are structural conditions that push people toward traditional and religious healing, sometimes by default rather than conviction.

The implications for health policy are significant. If patients routinely combine biomedical, traditional and faith-based care, then health systems that ignore or dismiss the latter two risk losing contact with the very populations they aim to serve. The study concludes that effective healthcare delivery in Debre Tabor City requires culturally responsive strategies that integrate biomedical, traditional and faith-based healing systems rather than treating them as separate or competing domains. Collaborative engagement with trusted community actors, including religious leaders and traditional healers, is identified as essential to enhance utilization of formal services and improve health outcomes.

Such collaboration could take many forms, from referral relationships between clinics and healers to health education delivered through religious institutions. The point is not to romanticize traditional medicine or to medicalize religion, but to recognize the empirical reality that patients already inhabit a plural therapeutic world. Programs that acknowledge this reality can meet people where they are, building on existing trust rather than demanding that patients abandon cultural frameworks before receiving care. In contexts of medical pluralism, the choice is rarely between tradition and science; it is about how the two can coexist in ways that protect patients.

As Ethiopia continues to expand access to healthcare, studies like this one offer a reminder that utilization is not determined by supply alone. Health-seeking behavior is deeply embedded in sociocultural contexts, and understanding those contexts is a prerequisite for designing interventions that actually work. The Debre Tabor findings, drawn from the voices of community members, healers, religious leaders and professionals alike, suggest that the path to better health outcomes runs through the community’s own map of meaning, not around it.

Subject of Research: Health-seeking behavior and medical pluralism in Debre Tabor City, Ethiopia

Article Title: Understanding health-seeking behavior at the intersection of culture, religion and traditional healing in Debre Tabor City, Ethiopia: a qualitative sociological inquiry

Article References: Dagnew, T. A. (2026). Understanding health-seeking behavior at the intersection of culture, religion and traditional healing in Debre Tabor City, Ethiopia: a qualitative sociological inquiry. International Journal for Equity in Health. https://doi.org/10.1186/s12939-026-03074-9

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03074-9

Keywords: health-seeking behavior, medical pluralism, Ethiopia, traditional healing, religion and health, qualitative research, medical sociology, Debre Tabor, sociocultural determinants, health equity, Kleinman explanatory model, community health