Traditional Healing Practices as a Complement or Barrier to Modern Orthopedic Care in White Nile State, Sudan 2024: A cross sectional study

ABSTRACT Introduction Traditional bone-setting remains a culturally significant healthcare practice in low- and middle-income countries, particularly in regions like Sudan where modern orthopedic services are often inaccessible or unaffordable .This study examines the role of traditional healing practices in orthopedic care in White Nile State, Sudan, assessing patient perceptions, treatment effectiveness, and sociocultural factors influencing healthcare choices. Methods A cross-sectional analytical study was conducted among 147 patients, 7 traditional healers, and 4 orthopedic practitioners in urban and rural areas of White Nile State. Data were collected using structured questionnaires and interviews, focusing on treatment preferences, perceived effectiveness, and barriers to integration. Descriptive and inferential statistics were used to analyze quantitative data, while thematic analysis was applied to qualitative responses from healers and practitioners. Results Fractures (45.6%) and arthritis (23.1%) were the most common orthopedic conditions. 30.6% of patients initially sought traditional treatment, all eventually utilized modern care (medication 71.4%, surgery 42.9%). Traditional healing was perceived as somewhat effective by 40% of users, whereas 59.9% rated modern care as very effective. Key factors influencing treatment choices included cultural beliefs (29.9%), accessibility (18.4%), and cost (16.3%). No significant demographic associations were found with treatment preference or effectiveness (p > 0.05). Traditional healers predominantly treated dislocations (100%) and fractures (71.4%) using manual techniques, with 57.1% referring complex cases to modern practitioners. Barriers to collaboration included lack of communication (85.7% of healers) and differing treatment philosophies (50% of practitioners). Conclusion This study highlights the persistent dual reliance on traditional and modern orthopedic care in Sudan, with modern treatments perceived as more effective yet traditional methods remaining culturally entrenched especially in rural areas. The path forward requires bridging these systems through mutual respect, shared protocols, and community engagement to ensure safe, equitable, and effective musculoskeletal care for all Sudanese patients.